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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B18 Bariatric Times • November 2016 • Supplement B FIRST INTERNATIONAL CONSENSUS CONFERENCE ON DUODENAL SWITCH ones receive smaller common channels. Currently, we use 180 cm on average as malabsorption is to be avoided and not produced. Results: Excessive Body Mass Index in percentage (EBMIL%) was 93, 91, 84.9, and 75.5 percent respectively in the first, third, fifth and tenth year. T2DM were present in 300 patients. Remission (Hba1c<6% without medication) in 260 patients (86.7%); 38 patients (12.7%) improved and 2 patients (0.7%) had no response. Radiographies show nutrient transit mainly through gastroileostomy. Three deaths occurred (0.2%). Other surgical complications were 5.5 percent, resolved without sequela. Resolution of other metabolic conditions is similar to those reported in BPDs although signals of malabsorption are infrequent. Published results of RYGB are usually inferior. In summary, SG+TB is simple and easily revertible. It maintains the positive results of a BPD; however, minimizing malabsorption, diarrhea, and flatulence. Weight and comorbidities are improved, similar to a BPD. Diabetes is improved significantly without a complete duodenal exclusion. Transit bipartition is an excellent complement to a sleeve gastrectomy. F i g u r e s 2 a n d 3 . A part i al bi l i opancreat i c bypass (pBPD). The st omach remai ns wi t h t wo exi t s. 1 2 REFERENCES 1. Holst JJ: Postprandial insulin secretion after gastric bypass surgery: the role of glucagon-like peptide 1. Diabetes. 2011;60:2203-2205. 2. Ziegler O, Sirveaux MA, Brunaud L, Reibel N, Quilliot D. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35:544–557. 3. Nauck MA1, Niedereichholz U, Ettler R, Holst JJ, Orskov C, Ritzel R, Schmiegel WH. Glucagon-like peptide 1 inhibition of gastric emptying outweighs its insulinotropic effects in healthy humans. Am J Physiol. 1997;273(5 Pt 1):E981-8. 4. Santoro S. From bariatric to pure metabolic surgery: new concepts on the rise. Ann Surg. 2015;262:79–80. 5. Meier JJ, Gallwitz B, Siepmann N, et al.Gastric inhibitory polypeptide (GIP) dose-dependently stimulates glucagon secretion in healthy human subjects at euglycaemia. Diabetologia. 2003;46:798–801. 6. Lam NT, Kieffer TJ. The multifaceted potential of glucagon-like peptide-1 as a therapeutic agent. Minerva Endocrinol. 2002;27:79–93. 7. Vilsboll T, Krarup T, Sonne J, et al. Incretin secretion in relation to meal size and body weight in healthy subjects and people with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab. 2003;88:2706– 2713. 8. Deschamps I, Heptner W, Desjeux JF, et al. Effects of diet on insulin and gastric inhibitory polypeptide levels in obese children. Pediatr Res. 1980;14:300–303. 9. Miyawaki K, Yamada Y, Ban N, et al. Inhibition of gastric inhibitory polypeptide signaling prevents obesity. Nat Med. 2002;8:738–742. 10. Irwin N, Flatt PR. Evidence for beneficial effects of compromised gastric inhibitory polypeptide action in obesity-related diabetes and possible therapeutic implications. Diabetologia. 2009;52:1724–1731. 11. Santoro S. Stomachs: does the size matter? Aspects of intestinal satiety, gastric satiety, hunger and gluttony. Clinics. 2012;67(4):301–303 12. Santoro S, Castro LC, Velhote MC, Malzoni CE, Klajner S, Castro LP, Lacombe A, Santo MA. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–110. V i e w a c c o m p a n y i n g v i d e o a t h t t p : / / i c c d s 1 . m e t a b o l i c s u r g e r y . t v

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