Sleeve to gastric bypass conversion: a multiinstitutional study of 217 patients.

Background: Revision of a sleeve gastrectomy (SG) to a Roux-en-Y gastric bypass (RYGB) is indicated for gastroesophageal reflux disease (GERD) and for weight recurrence. Existing literature is conflicting and lacks long-term follow-up.

Objectives: To evaluate the resolution of GERD and additional weight loss after conversion of SG to RYGB.

Impact of Ursodiol on Number of Cholecystectomies Performed After Bariatric Surgery.

Background: The risk of gallstone formation is greater in obese patients; paradoxically, the rapid weight loss after bariatric surgery (BS) is also a great contributor to cholelithiasis and biliary disease. While concomitant cholecystectomy has been used to mitigate this issue, the demand for a less invasive prophylaxis was met by ursodeoxycholic acid (UDCA). This study aims to evaluate the impact of UDCA on the incidence of cholecystectomies after BS.

Single-anastomosis duodenal-ileal bypass with sleeve gastrectomy for diabetes: predictors of remission and metabolic outcomes in a multicenter study.

Background: The single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) combines the restrictive aspects of a sleeve gastrectomy (SG) with the hypoabsorptive advantages of a gastric bypass. SADI-S has demonstrated excellent weight loss outcomes and technical feasibility.

Objectives: To evaluate the benefits of SADI-S in patients with obesity and type 2 diabetes mellitus.

Too Late for a Duodenal Switch? Safety and Effectiveness of Duodenal Switch in Patients over 60 Years Old.

Introduction: The increase in obesity prevalence and longer life expectancy has led to more candidates over 60 pursuing bariatric surgery. While multiple studies have investigated outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass in this age group, the outcomes of duodenal switch (DS) require further investigation. This study assessed the safety and effectiveness of DS in patients over 60 compared to those under 60.

Effect of Limb Length on Weight Loss Outcomes Following Biliopancreatic Diversion with Duodenal Switch: A Multi-Centered Study.

Purpose: The effectiveness of biliopancreatic diversion with duodenal switch (BPD/DS) for weight loss is well established, yet there remains ongoing debate over optimal limb lengths to maximize weight loss without compromising safety. We aimed to evaluate the impact of BPD/DS limb lengths on weight loss outcomes and comorbidity resolution.

Material And Methods: A multicenter review of patients who underwent primary BPD/DS between 2008 and 2022.

Internal hernia in patients after duodenal switch: A multi-centred comparative analysis.

Biliopancreatic diversion with duodenal switch (BPD-DS) and single anastomosis duodeno-ileostomy with sleeve (SADI-S) are associated with superior and sustained weight loss outcomes. Despite their growing popularity, long-term safety profiles, particularly the risk of internal hernia (IH), remain underexplored. This study aimed to evaluate the incidence and characteristics of IH following BPD-DS and SADI-S procedures, comparing their clinical presentation, diagnostic methods, and outcomes.

Single anastomosis duodenal switch versus Roux-en-Y gastric bypass in patients with BMI ≥ 50 kg/m: a multi-centered comparative analysis.

Background: Roux-en-Y gastric bypass (RYGB) has consistently demonstrated excellent weight loss and comorbidity resolution. However, outcomes vary based on patient's BMI. Single anastomosis duodeno-ileostomy with sleeve (SADI-S) is a novel procedure with promising short-term results.

Reflux After Sleeve Gastrectomy: Safety and Effectiveness of Laparoscopic Ligamentum Teres Cardiopexy, a Single-Center Experience.

Background: Obesity is a well-known risk factor for gastroesophageal reflux disease (GERD). Even though symptoms may be mitigated or resolved with the weight loss caused by sleeve gastrectomy (SG), it may be associated with higher incidences of postoperative GERD. Ligamentum teres cardiopexy (LTC) is an alternative to Roux-en-Y gastric bypass, the gold standard treatment for GERD.

Management of Malnutrition and Hepatic Impairment After Duodenal Switch.

Background: Malnutrition and liver impairment after duodenal switch (DS) are possible and undesired complications, often conservatively treated. However, in specific cases, surgical revision may be necessary. This study aims to describe outcomes achieved by two bariatric surgery centers and address effectiveness and safety of revisional surgical procedures to resolve these complications.

Comparative multicenter analysis of sleeve gastrectomy, gastric bypass, and duodenal switch in patients with BMI ≥70kg/m: a 2-year follow-up.

Patients undergoing metabolic and bariatric surgery (MBS) with body mass index (BMI) ≥ 70 kg/m are considered a high-risk group. There is limited literature to guide surgeons on the perioperative safety as well as the different procedural outcomes of MBS in this cohort. Our aim is to compare the safety profiles, early- and medium-term outcomes of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients with BMI ≥ 70 kg/m.

Marginal Ulcer and Dumping Syndrome in Patients after Duodenal Switch: A Multi-Centered Study.

Background: The current design of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodenal-ileal bypass with sleeve (SADI-S) emphasizes the importance of the pylorus' preservation to reduce the incidence of marginal ulcer (MU) and dumping. However, no institutional studies have yet reported data on their prevalence. We aimed to assess the incidence of MU and dumping after duodenal switch (DS) and identify the associative factors.

Long-Term Outcomes of Sleeve Gastrectomy: Weight Recurrence and Surgical Non-responders.

Introduction: Sleeve gastrectomy (SG) is an effective procedure with remarkable weight loss and low complication rates. However, up to 30% of cases require revisional surgery in non-responders or patients who experience weight recurrence. We aim to report the rate of weight recurrence/non-responders (WR/NR) in patients who underwent SG and had more than 5 years of follow-up.

Analysis of the Impact of the Learning Curve on the Safety Outcome of the Totally Robotic-Assisted Biliopancreatic Diversion with Duodenal Switch: a Single-Institution Observational Study.

Introduction: Totally robotic-assisted biliopancreatic diversion with duodenal switch (BPD/DS) learning curve has been described to be longer at approximately 50 cases, at which point operative time and complications rate decrease and tend to stabilize. This study aimed to form an analysis of the impact of the learning curve on the safety outcomes of the totally robotic-assisted BPD/DS.

Methods: A retrospective review of patients who underwent primary totally robotic-assisted BPD/DS by one of our certified bariatric and metabolic surgeon member of our institution was performed.

Implementing novel modalities into an institutional enhanced recovery after bariatric surgery (ERABS) protocol.

Introduction: Enhanced recovery after bariatric surgery pathways are associated with improved postoperative outcomes. This study aims to assess efficacy and safety of three novel protocol contributions (transversus abdominis plane blocks, ketamine and fosaprepitant), as well as their impact on length of stay (LOS) and on postoperative complications.

Methods: Effectiveness and safety were retrospectively investigated in patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) over a 6-year period in a single institution.

Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs.

Purpose: Postoperative nausea and vomiting (PONV) is one of the most common adverse effects of anesthesia and surgery, resulting in patient discomfort and dissatisfaction. Latest research has demonstrated the efficacy of NK-1 receptor antagonists in PONV management and its use in chemotherapy nausea prophylaxis. The authors of this article would like to provide evidence to support the use fosaprepitant, as monotherapy, in postoperative care, replacing a polypharmacological standard of care regimen.

Impact of Perioperative Ketamine on Postoperative Bariatric Surgery Opioid Use and Length of Stay.

Settings: Postoperative pain management is an ever-growing challenge with the rise of the opioid crisis. Ketamine is an NMDA channel blocker, considered an alternative to perioperative opioid use; small concentrations are safe. Objective: The primary objective of this study was to evaluate the impact of perioperative ketamine administration on postoperative opioid use and the length of hospital stay in bariatric patients.

Robot-assisted duodenal switch with DaVinci Xi: surgical technique and analysis of a single-institution experience of 661 cases.

Metabolic and bariatric surgery is an effective treatment for the management of obesity and related comorbidities. Although the duodenal switch has demonstrated superior results in terms of resolution of obesity-related comorbidities and weight loss, it is one of the less performed procedures. The use of robotic surgical platforms offers many advantages in obese patients and is particularly useful in technically demanding procedures such as duodenal switch.

Single- Versus Double-Anastomosis Duodenal Switch: Outcomes Stratified by Preoperative BMI.

Purpose: Describe and analyze the safety and weight loss performance of biliopancreatic diversion and duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), verifying any possible superiority according to preoperative BMI.

Methods: Retrospective review of patients who underwent primary SADI-S or BPD-DS in three bariatric centers. Study groups were further stratified according to preoperative BMI (subgroup 1: BMI < 50; subgroup 2: 50 ≤ BMI < 55; subgroup 3: BMI ≥ 55).

Duodenal Switch Conversion in Non-responders or Weight Recurrence Patients.

Introduction: Several modalities have been proposed to tackle insufficient weight loss and weight regain after bariatric surgery; we aimed to evaluate efficacy and safety of duodenal switch conversion as a salvage procedure.

Material And Methods: Data from patients who underwent duodenal switch conversions (n = 50) were retrospectively studied. Excess weight loss % and total body weight loss % were compared between primary procedure and duodenal switch conversion.

Single-center experience in single-stage conversions of gastric banding to sleeve gastrectomy: is it as safe as 2-stage conversions?

Background: Laparoscopic sleeve gastrectomy (LSG) can be performed after obesity persistence following laparoscopic adjustable gastric banding (LAGB) with a positive safety profile. However, some argue that the conversion should be performed in 2 stages rather than 1 because of perioperative complications. The aim of this study is to determine the safety profile of single-stage LAGB to LSG conversion.