Conversion from Duodenal Switch to Single Anastomosis Duodenal Switch to Deal with Postoperative Malnutrition
- PDF / 619,907 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 51 Downloads / 273 Views
NEW CONCEPT
Conversion from Duodenal Switch to Single Anastomosis Duodenal Switch to Deal with Postoperative Malnutrition Javier Baltar 1 & Aurelio Martis-Sueiro 2 & María Pardo 3 & Fernando Santos 1 & Maria Isabel Sartal 1 & Ana B. Crujeiras 3 & Roberto Peinó 2 & Luisa María Seoane 3 & María Bárcena 4 & Manuel Bustamante 1 Received: 27 March 2020 / Revised: 3 October 2020 / Accepted: 6 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Duodenal switch (DS) is considered one of the most effective bariatric techniques for long-term weight and comorbidity control. After these operations, some patients may get severe complications related to malnutrition and a few of them may need surgical revision. Lengthening the common channel (CC) is usually the solution: changing the Roux anastomosis or with a side-to-side anastomosis (kissing X). We propose that when simplified construction of the DS is used, conversion to single anastomosis DS (SADI-S/OADS) is an easy and safe choice. Objectives To evaluate the safety and effectiveness of conversion from DS to SADI-S in cases of malnutrition. Methods We report three patients with severe malnutrition after a DS at 9, 74, and 84 months. One of them had also liver failure related to alcohol abuse and malnutrition. Laparoscopic reoperations included a new ileo-ileal anastomosis and takedown of the Roux-en-Y anastomosis with the aim of lengthening the CC. Results All three patients were successfully converted by laparoscopy. After a median follow-up of 54.6 months [32–76 months], all of them had moderate weight regain and returned to normal biochemical nutritional parameters. Two patients with type 2 diabetes (T2DM) before DS had complete remission before conversion; one of them had recurrence of T2DM after conversion. The patient with liver failure improved significantly after conversion.
Presented as a communication at the 24th World IFSO Congress, Madrid, September 2019 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-05047-5) contains supplementary material, which is available to authorized users. * Javier Baltar [email protected]
María Bárcena [email protected]
Aurelio Martis-Sueiro [email protected] María Pardo [email protected]
Manuel Bustamante [email protected] 1
Servicio de Cirugía General y del Aparato Digestivo, CHU Santiago de Compostela, Rua R Baltar s/n, 15706 Santiago de Compostela, Spain
Maria Isabel Sartal [email protected]
2
Servicio de Endocrinología, CHU Santiago de Compostela, Santiago de Compostela, Spain
Ana B. Crujeiras [email protected]
3
Grupos de Obesidómica (MP), Epigenomica (ABC) y Fisiopatolgía Endocrina (LMS) del Area de Endocrinología, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
4
Servicio de Anestesiología y Reanimación, CHU Santiago de Compostela, Santiago de
Data Loading...
