Bariatric Times

Sleeve Gastrectomy 2015

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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April 2015 • Supplement A • Bariatric Times A19 5 th INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY protein-rich liquid diet on the following day and was discharged o n Postoperative Day 2. There were no intraoperative or perioperative complications. At the time this article was completed, we did not have any data to report beyond her t wo-week postoperative visit, where she was 11 pounds lighter. DISCUSSION According to the literature, outcomes from the loop duodenal switch have been encouraging. Sánchez-Pernaute et al in Madrid, Spain, have recently reported a mean excess weight loss (EWL) of 72 percent at two-year followup, and remission rates of 88, 60, and 40 perent for diabetes, hypertension, and dyslipidemia, respectively, in patients undergoing SADI as a second procedure after sleeve gastrectomy. 1 These outcomes are even better when the loop duodenal switch is performed as primary operation with a sleeve gastrectomy. Here, the mean EWL was over 95 percent at one-year follow up, and remission of diabetes was over 90 percent. 2 CONCLUSION The current case demonstrates that the loop duodenal switch is feasible and safe, despite the increased perioperative risk factors in our patient. Given these findings, the loop duodenal switch should be a viable option given to patients that fail to lose weight after a sleeve gastrectomy. The relative infancy of this procedure does also mean that long-term prospective studies are needed to determine if these outcomes are durable and still with minimal surgical and nutritional complications. REFERENCES 1. Sánchez-Pernaute A, Rubio MA, Conde M, et al. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2014 Jul 10. pii: S1550-7289(14)00267-6. [Epub ahead of print] 2. Sánchez-Pernaute A, Rubio MA, Aguirre EP, et al. Single- anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis. 2013;9:731–735. Figure 1. Illustrated here is a loop duodenal switch on a former sleeve patient. Duodeno-ileal anastomosis is approximately 300cm proximal to the ileal- cecal junction.

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