Romulo Lind1, Omar M Ghanem2, Muhammad Ghanem3, Andre F Teixeira3, Muhammad A Jawad3. 1. Department of Bariatric Surgery, Orlando Regional Medical Center, 89 W Copeland Dr, 1st Floor, Orlando HealthOrlando, FL, USA. Romulo.lind@orlandohealth.com. 2. Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA. 3. Department of Bariatric Surgery, Orlando Regional Medical Center, 89 W Copeland Dr, 1st Floor, Orlando HealthOrlando, FL, USA.
Abstract
INTRODUCTION: Several modalities have been proposed to tackle insufficient weight loss and weight regain after bariatric surgery; we aimed to evaluate efficacy and safety of duodenal switch conversion as a salvage procedure. MATERIAL AND METHODS: Data from patients who underwent duodenal switch conversions (n = 50) were retrospectively studied. Excess weight loss % and total body weight loss % were compared between primary procedure and duodenal switch conversion. Overall complication, emergency department visits, readmissions, reoperation, and mortality rates were described, analyzed, and compared to the current literature. RESULTS: Every excess weight loss % and total body weight loss % comparison at 6, 12, and 24 months, demonstrated a statistically significant superiority in weight loss after duodenal switch conversion (p < 0.05). The mean operative time of adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass (1 and 2 stages) conversions to duodenal switch were 208, 146, 187, and 152 min, respectively, while the mean length of stay was 3.38 days. No statistically significant differences were perceived regarding the primary procedure. The overall complication rate was 18% (9 patients); 3 patients (6%) had 1 emergency department visit; readmissions accounted for 12% of cases (6 patients); the reoperation rate was 10% (5 patients); no fatal outcomes were recorded. CONCLUSION: Duodenal switch conversions are an effective salvage procedure for insufficient weight loss and/or weight regain after adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass; it is also safe, associated to low readmission, reoperation, and mortality rates.
INTRODUCTION: Several modalities have been proposed to tackle insufficient weight loss and weight regain after bariatric surgery; we aimed to evaluate efficacy and safety of duodenal switch conversion as a salvage procedure. MATERIAL AND METHODS: Data from patients who underwent duodenal switch conversions (n = 50) were retrospectively studied. Excess weight loss % and total body weight loss % were compared between primary procedure and duodenal switch conversion. Overall complication, emergency department visits, readmissions, reoperation, and mortality rates were described, analyzed, and compared to the current literature. RESULTS: Every excess weight loss % and total body weight loss % comparison at 6, 12, and 24 months, demonstrated a statistically significant superiority in weight loss after duodenal switch conversion (p < 0.05). The mean operative time of adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass (1 and 2 stages) conversions to duodenal switch were 208, 146, 187, and 152 min, respectively, while the mean length of stay was 3.38 days. No statistically significant differences were perceived regarding the primary procedure. The overall complication rate was 18% (9 patients); 3 patients (6%) had 1 emergency department visit; readmissions accounted for 12% of cases (6 patients); the reoperation rate was 10% (5 patients); no fatal outcomes were recorded. CONCLUSION: Duodenal switch conversions are an effective salvage procedure for insufficient weight loss and/or weight regain after adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass; it is also safe, associated to low readmission, reoperation, and mortality rates.
Authors: Benjamin Clapp; Joseph N Badaoui; Jesus A Gamez; Andres Vivar; Omar M Ghanem Journal: Surg Obes Relat Dis Date: 2021-07-06 Impact factor: 4.734
Authors: Alexa E Merz; Robin B Blackstone; Michel Gagner; Antonio J Torres; Jacques Himpens; Kelvin D Higa; Raul J Rosenthal; Aaron Lloyd; Eric J DeMaria Journal: Surg Obes Relat Dis Date: 2019-03-21 Impact factor: 4.734
Authors: Nicholas L Syn; David E Cummings; Louis Z Wang; Daryl J Lin; Joseph J Zhao; Marie Loh; Zong Jie Koh; Claire Alexandra Chew; Ying Ern Loo; Bee Choo Tai; Guowei Kim; Jimmy Bok-Yan So; Lee M Kaplan; John B Dixon; Asim Shabbir Journal: Lancet Date: 2021-05-06 Impact factor: 79.321