Midterm Results from the Dutch Common Channel Trial (DUCATI): Superior Weight Loss Results of the Long Roux Limb Gastric Bypass in Comparison to the Standard Bypass at 3-Year Follow-Up

2021 ◽  
Author(s):  
Ralph P. M. Gadiot ◽  
L. Ulas Biter ◽  
Pierre G. Feskens ◽  
Martin Dunkelgrun ◽  
Jan A. Apers ◽  
...  
2021 ◽  
Author(s):  
Arnaud Liagre ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  

Abstract Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alaa Abbas Sabry ◽  
Karim Sabry Abd-Elsamee ◽  
Mohamed Ibrahim Mohamed ◽  
Mohammed Mohamed Ahmed Abd-Elsalam

Abstract Background It is already known that Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain is considered as a complication. Demand for secondary surgery is rising, partly for this reason, but through that study we try to discover the efficacy of conversion of failed sleeve gastrectomy to one anastomosis gastric bypass (OAGB) regarding weight loss and metabolic outcomes. Objective To asses the efficacy and safety of one anastomosis gastric bypass (OAGB) as a conversion surgery post Sleeve Gastrectomy failure as regard weight loss and metabolic outcomes. Patients and Methods This study is a retrospective cohort study which included 20 patients underwent one anastomosis gastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric center, Cairo, Egypt From February 2019 to July 2019 with 6 months of postoperative follow up till January 2019. Results In this study, we reviewed and analyzed the outcomes from the revision of the SG due to either inadequate weight loss or weight regain to one anastomosis gastric bypass (OAGB) with %EBWL of 6.65% at 1 month, 13.61 % at 3 months and 20.86% at 6 months. Conclusion OAGB appears to be an effective and safe therapeutic technique as a revisional surgery for failed primary SG with good short-term results for treating morbid obesity and its associated comorbidities with a significantly low rate of complications. However the EBWL was less than what is reported after primary OAGB weight. Multicenter studies with larger series of patients and longer term follow up after SG revisions to OAGB are warranted.


Heart Rhythm ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Stephen L. Wasmund ◽  
Theophilus Owan ◽  
Frank G. Yanowitz ◽  
Ted D. Adams ◽  
Steven C. Hunt ◽  
...  

2020 ◽  
Author(s):  
Thales Philipe Rodrigues Silva ◽  
Flávia Moraes Silva ◽  
Larissa Loures Mendes ◽  
Alexandra Dias Moreira D'assunção ◽  
Lauro Pinheiro Ferreira de Araujo ◽  
...  

Abstract INTRODUCTION: Roux-en-Y gastric bypass surgery (RYGB) is known to induce, on average,60 to 75% excess body weight loss between 18 and 24 months post-surgery. However, several studies have shown weight regain after two years post-surgery, thus patients must have adequate follow-up in order to guarantee and/or maintain response to RYGB. AIM: To evaluate the determinants of adequate response in patients who underwent RYGB. METHODS: A longitudinal study with 193 adults who underwent RYGB between 2012 and 2014. Adequate response to RYGB was determined by Excess Weight Loss (%EWL). Logistic regression models were constructed to verify the degree of association between adequate response of patient after RYGB and determinants of variable risk based on estimate Odds Ratios (OR). RESULTS: RYGB improves Systemic arterial hypertension (SAH), Diabetes Mellitus (DM) and body mass index (BMI). From the multivariate logistic regression model, being female and not having SAH and DM reduce the chance of inadequate RYGB response. Regarding preoperative BMI, an increase in one unit of kg/m2 was associated with increased odds of inadequate response after RYGB. And patients who did not receive follow-up care with a psychologist or psychiatrist in the postoperative period presented higher odds of inadequate response to RYGB. CONCLUSION: The findings of this study contribute to the effective planning of interventions by multi-professional teams involved in RYGB, aimed at offering a better follow-up care focused mainly on post-surgery changes and adequate RYGB response.


2020 ◽  
Vol 123 (12) ◽  
pp. 1434-1440 ◽  
Author(s):  
M. Leeman ◽  
R. P. M. Gadiot ◽  
J. M. A. Wijnand ◽  
E. Birnie ◽  
J. A. Apers ◽  
...  

AbstractLaparoscopic Roux-en-Y gastric bypass (RYGB) is considered the ‘gold standard’ for surgical treatment of morbid obesity. It is hypothesised that reducing the length of the common limb positively affects the magnitude and preservation of weight loss but may also impose a risk of malnutrition. The aim of this study was to compare patients’ nutrient and vitamin deficiencies in standard RYGB with a very long Roux limb RYGB (VLRL-RYGB). This study was part of the multicentre randomised controlled trial (Dutch Common Channel Trial), including 444 patients undergoing an RYGB or a VLRL-RYGB. Laboratory results, use of multivitamin supplements and reoperations were collected at baseline and 1 year postoperative. Primary outcome measure was nutrient deficiency after 1 year postoperative. Secondary outcome measure was the reoperation rate due to malabsorption. In total, 227 patients underwent RYGB and 196 patients underwent VLRL-RYGB. Most common deficiencies at 1 year postoperative were ferritin (17·2–18·2 %), Fe (23·4–35·6 %), K (7·4–15·2 %), vitamin B12 (9·0–9·9 %) and vitamin D (22·7–34·5 %). Patients undergoing VLRL-RYGB had slightly but significantly lower levels of Ca, Fe and vitamin D compared with those undergoing RYGB at 1 year postoperative, but significantly higher levels of folic acid and Na. Reoperation rates due to malabsorption were not significantly different between RYGB (2/227, 0·9 %) and VLRL-RYGB (7/196, 3·6 %) (P = 0·088). We concluded that patients undergoing VLRL-RYGB had significantly lower levels of Ca, Fe and vitamin D compared with those undergoing RYGB at 1 year postoperative, but higher levels of folic acid and Na. Reoperation rates did not differ. Close monitoring on nutrient deficiencies should be performed in patients undergoing VLRL-RYGB.


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mohsen Mahmoudieh ◽  
Behrouz Keleidari ◽  
Naser Afshin ◽  
Masoud Sayadi Shahraki ◽  
Shahab Shahabi Shahmiri ◽  
...  

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods. 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients’ BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.


Sign in / Sign up

Export Citation Format

Share Document