Bariatric Surgery information
Vertical Banded Gastroplasty Revision to Duodenal Switch

Gastric Bypass Revision Improves Dyslipoproteinemia and Hypercholesterolemia After VBG

Bariatric Surgery - Bariatric Research Studies

Improvement of weight loss and metabolic effects of vertical banded gastroplasty by an added duodenal switch procedure

Some 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:
Yashkov YI, Oppel TA, Shishlo LA, Vinnitsky LI. Dept. of Liver, Bile Ducts and Pancreatic Surgery, Russian Research Center of Surgery RAMS, Moscow, Russia. 2001

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources