Bariatric Times

ICCDS-1 2016

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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November 2016 • Supplement B • Bariatric Times B9 FIRST INTERNATIONAL CONSENSUS CONFERENCE ON DUODENAL SWITCH It is obvious that this operation is not for every patient or for every s urgical practice, and choosing the right patient is extremely difficult. The successful outcome of reaping the benefits of the sustained weight loss of the DS while not developing n utritional deficiencies depends on patient compliance. A cogent argument could be made that staging this operation as an initial sleeve gastrectomy to be followed (or not) by an intestinal bypass is the best way to evaluate patient's compliance. Short-term (<2 years) published data for single anastomosis duodenal intestinal (SADI) patients by other groups also shows nutritional deficiencies 9 and these patients will also require intensive long-term follow up. Finally, we may have to revisit the idea of concomitant cholecystectomy as at least one- fifth of our patients eventually required this operation in a long- term follow-up period. REFERENCES 1. Marceau P, Biron S, Bourque RA et al Biliopancreatic Diversion with a New Type of Gastrectomy. Obes Surg. 1993;3(1):29–35 2. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8 (3):267–282. 3. Prachand VN, Ward M, Alverdy JC. Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI > or = 50 kg/m2) compared with gastric bypass. J Gastrointest Surg. 2010; 14 (2):211–220. 4. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013; 310 (22):2416–2425. 5. American Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers, 2011- 2015. https://asmbs.org/resources/estimat e-of-bariatric-surgery-numbers. Accessed July 29, 2016. 6. Sethi M, Chau E, Youn A, et al. Long-term outcomes after biliopancreatic diversion with and without duodenal switch: 2-, 5-, and 10-year data. Surg Obes Relat Dis. 2016 Mar 9. [Epub ahead of print] 7. Strain GW, Torghabeh MH, Gagner M, et al. The impact of biliopancreatic diversion with duodenal switch (BPD/DS) over 9 years. Obes Surg. 2016 Sep 29. [Epub ahead of print] 8. Bardaro SJ, Gagner M, Consten E, et al Routine cholecystectomy during laparoscopic biliopancreatic diversion with duodenal switch is not necessary. Surg Obes Relat Dis. 2007;3(5):549–553. 9. Cottam A, Cottam D, Roslin M, et al. A matched cohort analysis of sleeve gastrectomy with and without 300 cm loop duodenal switch with 18-month follow-up. Obes Surg. 2016 Mar 18 [Epub ahead of print] TABLE 5. Biliopancreatic diversion/duodenal switch supplements High potency MV containing 200% daily value of nutrients 1800–2400 mgs elemental calcium citrate Elemental iron minimum 18–27 mg/d Fat soluble vitamins- water soluble sources preferred •10,000 IU of vitamin A • 2000 IU of vitamin D • 300 µg of vitamin K Optional B50 complex From Goldenberg L, Pomp A. Management of nutritional complications. In: Nguyen NT, Blackstone RP, Morton JM, Ponce J, Rosenthal R. (Eds.) The ASMBS Textbook of Bariatric Surgery. Springer, New York; 2015: 257–266

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