Department of Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Yude Rd., North Dist, Taichung, Taiwan.
Departmentof Bariatric and Gastrointestinal Surgery, Noble Gastro Hospital, Ahmedabad, India.
Obes Surg. 2024 Aug;34(8):2914-2922. doi: 10.1007/s11695-024-07348-5. Epub 2024 Jun 13.
Loop duodenojejunal bypass with sleeve gastrectomy (LDJBSG) is effective for weight loss and resolution of obesity-related associated medical problems. However, a description of the reoperative surgery following LDJBSG is lacking.
In this retrospective study, we analyzed the surgical complications and reoperation (conversion or revision) following LDJBSG from 2011 to 2019 in a single institution.
A total of 337 patients underwent LDJBSG during this period. Reoperative surgery (RS) was required in 10LDJBSG patients (3%). The mean age and BMI before RS were 47 ± 9 years and 28.9 ± 3.6 kg/m, respectively. The mean interval between primary surgery and RS for early (n = 5) and late (n = 5)complications was 8 ± 11 days and 32 ± 15.8 months, respectively. The conversion procedures were Roux-en-Y gastric bypass(n = 5), followed by Roux-en-Y duodenojejunal bypass (n = 2) and one-anastomosis gastric bypass (n = 1); other revision procedures were seromyotomy (n = 1) and re-laparoscopy (n = 1). Perioperative complications were observed in four patients after conversion surgery such as multiorgan failure (n = 1), re-laparoscopy (n = 1), marginal ulcer (n = 1), GERD (n = 1), and dumping syndrome (n = 1).
LDJBSG has low reoperative rates and conversion RYGB could effectively treat the early and late complications of LDJBSG. Because of its technical demands and risk of perioperative complications, conversion surgery should be reserved for a selected group of patients and performed by an experienced metabolic bariatric surgical team.
空肠-十二指肠旁路袖状胃切除术（LDJBSG）对于减轻体重和解决肥胖相关的医学问题非常有效。然而，对于 LDJBSG 后的再次手术，目前还缺乏描述。
在这项回顾性研究中，我们分析了 2011 年至 2019 年在一家机构中接受 LDJBSG 的患者的手术并发症和再次手术（转换或修正）。
在这段时间内，共有 337 例患者接受了 LDJBSG。10 例 LDJBSG 患者（3%）需要再次手术（RS）。RS 前的平均年龄和 BMI 分别为 47 ± 9 岁和 28.9 ± 3.6 kg/m2。早期（n = 5）和晚期（n = 5）并发症的原发手术后到 RS 的平均间隔时间分别为 8 ± 11 天和 32 ± 15.8 个月。转换手术包括 Roux-en-Y 胃旁路术（n = 5），其次是 Roux-en-Y 空肠-十二指肠旁路术（n = 2）和单吻合胃旁路术（n = 1）；其他修正手术包括浆膜切开术（n = 1）和再腹腔镜检查（n = 1）。在转换手术后，有 4 例患者出现围手术期并发症，包括多器官功能衰竭（n = 1）、再腹腔镜检查（n = 1）、边缘性溃疡（n = 1）、胃食管反流病（n = 1）和倾倒综合征（n = 1）。
LDJBSG 的再次手术率较低，转换为 Roux-en-Y 胃旁路术可以有效地治疗 LDJBSG 的早期和晚期并发症。由于其技术要求和围手术期并发症的风险，转换手术应保留给一组选定的患者，并由经验丰富的代谢减重外科手术团队进行。
