Pylorus preserving loop duodeno-enterostomy with sleeve gastrectomy - preliminary results

BMC Surgery

Research Article

Katharina Schmidt¹  W Konrad Karcz¹  Simon Kuesters²  Jodok Matthias Grueneberger²  Goran Marjanovic²  Krystyna Zwirska-Korczala³  Iwona Karcz-Socha³ 

[1] Department of General Surgery, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany;Department of General and Visceral Surgery, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany;Department of Physiology, Silesian Medical University, Katowitz, Poland;

关键词: Gastric Bypass;    Sleeve Gastrectomy;    Common Channel;    Marginal Ulcer;    Limb Length Variation;   

DOI  :  10.1186/1471-2482-14-20

 received in 2013-09-11, accepted in 2014-03-27,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundBariatric operations mostly combine a restrictive gastric component with a rerouting of the intestinal passage. The pylorus can thereby be alternatively preserved or excluded. With the aim of performing a “pylorus-preserving gastric bypass”, we present early results of a proximal postpyloric loop duodeno-jejunostomy associated with a sleeve gastrectomy (LSG) compared to results of a parallel, but distal LSG with a loop duodeno-ileostomy as a two-step procedure.Methods16 patients underwent either a two-step LSG with a distal loop duodeno-ileostomy (DIOS) as revisional bariatric surgery or a combined single step operation with a proximal duodeno-jejunostomy (DJOS). Total small intestinal length was determined to account for inter-individual differences.ResultsMean operative time for the second-step of the DIOS operation was 121 min and 147 min for the combined DJOS operation. The overall intestinal length was 750.8 cm (range 600-900 cm) with a bypassed limb length of 235.7 cm in DJOS patients. The mean length of the common channel in DIOS patients measured 245.6 cm. Overall excess weight loss (%EWL) of the two-step DIOS procedure came to 38.31% and 49.60%, DJOS patients experienced an %EWL of 19.75% and 46.53% at 1 and 6 months, resp. No complication related to the duodeno-enterostomy occurred.ConclusionsLoop duodeno-enterosomies with sleeve gastrectomy can be safely performed and may open new alternatives in bariatric surgery with the possibility for inter-individual adaptation.

【 授权许可】

CC BY   
© Grueneberger et al.; licensee BioMed Central Ltd. 2014