Reoperative Sleeve Gastrectomy After Biliopancreatic Duodenal Switch
Reduction of Gastric Sleeve
| Bariatric Surgery information Reoperative Sleeve Gastrectomy After Biliopancreatic Duodenal Switch |
Reduction of Gastric Sleeve |
| Laparoscopic Reoperative Sleeve Gastrectomy for Poor Weight Loss After Biliopancreatic Diversion Bypass with Duodenal Switch The revisional surgery for patients with inadequate weight loss after biliopancreatic diversion with duodenal switch (BPD/DS) is controversial. It has not yet been determined whether a common channel should be shortened or gastric pouch volume reduced. Since the revision of the distal anastomosis remains technically difficult and associated with possible complications, we turned our attention to the reduction of gastric sleeve volume. This operation is more feasible and potential complications are less probable. Method We present the case of a 47-year-old women with a life-long history of morbid obesity. She was operated on in January 2000 with a laparoscopic BPD/DS with 100 ml gastric pouch, 150 cm of alimentary limb and 100 cm of common channel. Before this operation, her weight was 170 kg, with BMI 64 kg/m(2). She lost most of her excess weight within 17 months after surgery and was regaining weight at 77 kg and BMI 29 kg/m(2). Upper GI series showed a markedly dilated gastric pouch. Her second surgery consisted of a laparoscopic sleeve partial gastrectomy along the greater curvature using endo GIA staplers with bovine pericardium for reinforcement of the stapler line. Results No post-operative complications occurred. The patient was discharged on the first post-operative day. Significant further weight reduction was noted, and at 10 months after surgery, her weight is 61 kg with BMI 22. Conclusion A repeat laparoscopic gastric sleeve resection was performed for inadequate weight loss after BPD/DS, and resulted in further weight reduction. Source: Surgery to Reduce Obesity |