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 B31 FIRST INTERNATIONAL CONSENSUS CONFERENCE ON DUODENAL SWITCH Concerning the new variants of this surgery, SADI/SIPS appears to b e technically easier (81% agree), and weight loss compared to standard DS may not be similar (32%), unknown (47%). A similar pattern of responses was given w hen questioned on malnutrition, GI side effects, remission of type 2 diabetes, early- and long-term complications. Participants of this consensus believe that in the next few years these questions will be answered, and this may explain the recent position of the American Society for Metabolic and Bariatric Surgery (ASMBS), stating that this is an "experimental procedure." Concerning the use of DS as a revision/salvage for the stand alone sleeve gastrectomy, there were strong answers supporting it for the management of weight regain after sleeve (100%), as well for persisting type 2 diabetes, and after weight regain from gastric banding or Roux-en-Y gastric bypass (RYGB). Options to revise a DS usually concerns making more restriction or increasing hypoabsorption. Participants were m ore on the side of a re-sleeve, increasing restriction for the infrequent weight loss failure after DS. The operation seems to have acceptability problems, mainly that p articipants believed that the main limitations to DS acceptance are technical difficulties (65%), risk of malnutrition (94%), vitamin deficiencies (88%), but less for side effects (74%), and not due to insurance coverage. We finish the conference with a lot on enthusiasm, as this core of strong believers in this operation wants to continue to educate younger surgeons on the benefits and management of this procedure and disseminate knowledge rapidly. On that note, we are going to have the 2nd International Consensus Conference on Duodenal Switch in Niagara Falls on May 28 to 29, 2017, and you are all invited to join us and participate. REFERENCES 1 . Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10(6):514–523 2. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–1832. 3. Gagner M. Hypoabsorption Not Malabsorption, Hypoabsorptive Surgery and Not Malabsorptive Surgery. Obes Surg. 2016 Aug 30. [Epub ahead of print] 4. Sánchez-Pernaute A, Rubio Herrera M A, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17(12):1614-8. Epub 2007 Nov 27. 5. Mitzman B, Cottam D, Goriparthi R, Cottam S, Zaveri H, Surve A, Roslin MS. Stomach intestinal pylorus sparing (SIPS) surgery for morbid obesity: Retrospective analyses of our preliminary experience. Obes Surg. 2016;26(9):2098–2104. 6. Biertho L, Simon-Hould F, Marceau S, Lebel S, Lescelleur O, Biron S. Current outcomes of laparoscopic duodenal switch. Ann Surg Innov Res. 2016;10:1.

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