Kamal K Mahawar1,2, Kuldeepak Singh Kular3, Chetan Parmar4, Michael Van den Bossche5, Yitka Graham6,7, William R J Carr6, Brijesh Madhok8, Conor Magee9, Sanjay Purkayastha10, Peter K Small6,7. 1. Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. kamal_mahawar@hotmail.com. 2. Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, UK. kamal_mahawar@hotmail.com. 3. Kular Hospital, Bija, Khanna, Punjab, India. 4. Whittington Hospital, London, UK. 5. Spire Southampton Hospital, Southampton, UK. 6. Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. 7. Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, UK. 8. Royal Derby Hospital, Derby, UK. 9. Arrowe Park Hospital, Wirral, UK. 10. Imperial College, London, UK.
Abstract
BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB. METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included. RESULTS: Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation. CONCLUSION: This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.
BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB. METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included. RESULTS: Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation. CONCLUSION: This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.
Entities:
Keywords:
Cancer; Mini gastric bypass; Objections; Omega loop gastric bypass; One anastomosis gastric bypass; Perioperative practices; Single anastomosis gastric bypass
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