Lind Romulo, Ghanem Omar M, Ghanem Muhammad, Teixeira Andre F, Jawad Muhammad A
Department of Bariatric Surgery, Orlando Regional Medical Center, 89 W Copeland Dr, 1st Floor, Orlando HealthOrlando, FL, USA.
Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
Obes Surg. 2022 Dec;32(12):3984-3991. doi: 10.1007/s11695-022-06297-1. Epub 2022 Oct 8.
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.
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.
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.
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.
已经提出了几种方法来解决减肥手术后体重减轻不足和体重反弹的问题；我们旨在评估十二指肠转流术作为补救手术的疗效和安全性。
对接受十二指肠转流术转换（n = 50）的患者数据进行回顾性研究。比较初次手术和十二指肠转流术转换后的超重减轻百分比和总体体重减轻百分比。描述、分析了总体并发症、急诊科就诊、再次入院、再次手术和死亡率，并与当前文献进行比较。
在6、12和24个月时，每次超重减轻百分比和总体体重减轻百分比的比较均显示，十二指肠转流术转换后的体重减轻在统计学上具有显著优势（p < 0.05）。可调节胃束带术、袖状胃切除术、Roux-en-Y胃旁路术（1期和2期）转换为十二指肠转流术的平均手术时间分别为208、146、187和152分钟，而平均住院时间为3.38天。在初次手术方面未观察到统计学上的显著差异。总体并发症发生率为18%（9例患者）；3例患者（6%）有1次急诊科就诊；再次入院占病例的12%（6例患者）；再次手术率为10%（5例患者）；未记录到致命结果。
十二指肠转流术转换是一种有效的补救手术，可用于解决可调节胃束带术、袖状胃切除术和Roux-en-Y胃旁路术后体重减轻不足和/或体重反弹的问题；它也是安全的，再次入院、再次手术和死亡率较低。
