Vertical Banded Gastroplasty Revision to Duodenal Switch
Gastric Bypass Revision Improves Dyslipoproteinemia and Hypercholesterolemia After VBG
| Bariatric Surgery information Vertical Banded Gastroplasty Revision to Duodenal Switch |
Gastric Bypass Revision Improves Dyslipoproteinemia and Hypercholesterolemia After VBG |
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Weight Loss Surgery Information - Bariatric Research Studies |
Improvement of weight loss and metabolic effects of vertical banded gastroplasty by an added duodenal switch procedureSome patients who underwent vertical banded gastroplasty need revisional operations because of poor weight loss and remaining comorbidities. The duodenal switch (DS) procedure with partial gastrectomy is known as an effective method for treatment of severe obesity and related dyslipoproteinemias and diabetes mellitus type 2 (DM2). Other investigations have shown that duodenal switch without gastric resection similarly corrects hypercholesterolemia and DM2 in the "less than" morbidly obese patients. Method Based on this knowledge, we performed a duodenal switch simultaneously with hernioplasty and panniculectomy in a 63-year-old woman with a fair EWL (36.4%), with remaining hypercholesterolemia and DM2 4 years after vertical banded gastroplasty. The pouch stoma diameter was 13 mm, and there was no pouch dilation nor staple-line disruption. The previously partitioned stomach was left in place. H2-blockers and polyvitamins were prescribed after operation. Results 1 year after DS there were no postoperative complications and undesirable effects except slight anemia. Duodenal switch allowed improvement in weight loss, improved carbohydrate handling without need for insulin or other hypoglycemic agents, and corrected severe hypercholesterolemia. Conclusion Duodenal switch per se in the case presented had a decisive effect on DM2 and hypercholesterolemia. Duodenal switch should be kept in mind as a second-step malabsorptive procedure after a failed purely restrictive operation. Source: Bariatric Weight Loss Surgery |