Resolution of comorbidities and outcomes after revision of sleeve gastrectomy to duodenal switch for patients with <scp>body mass index</scp> more than 60 kg/m<sup>2</sup>
No Thumbnail Available
Authors
Ghosh, A.
Hussein, A.
Askari, A.
Jain, V.
Adil, M.T.
Issue Date
2022
Type
Scientific Paper
Language
Keywords
Research Subject Categories::MEDICINE::Surgery
Alternative Title
Abstract
Abstract
Aim
Patients with body mass index (BMI) more than 60 kg/m2 pose unique challenges in management and their ability to lose significant weight after a single-stage bariatric procedure is debatable. The aim of this study is to explore resolution of comorbidities and report quality of life (QoL) in patients who have a laparoscopic sleeve gastrectomy (LSG) revised to duodenal switch (DS).
Methods
Patients who completed two-stage DS from 1 January 2011 to 31 December 2017 were analysed for excess weight loss (EWL), total weight loss (TWL), resolution of comorbidities and QoL. Validated questionnaires were used to assess QoL.
Results
A total of 9/1975 bariatric patients underwent two-stage DS during the study period, all of whom had had a previous LSG. The median preoperative weight before the first stage was 207.0 kg [interquartile range (IQR) 175.3-278.9 kg] and the median BMI was 75.0 kg/m2 (IQR 65.1-92.0 kg/m2). Length of hospital stay following the first stage (ie, LSG) was a median of 1 day (IQR 1-2 days) and 2 days (IQR 1-3 days) after revision to DS. The median EWL following LSG was 58.0% (IQR 33.3%-100.8%) and the median TWL was 16.1% (IQR 13.7%-25.2%). Following DS, the median EWL was 57.1% (IQR 47.1%-60.8%) and the median TWL was 21.2% (IQR 19.5%-26.7%). Significant improvement in obesity-related comorbidities were observed. QoL improved in overall feeling, physical activity, social life, work and approach to food. No immediate postoperative complications were observed. Long-term outcome of all patients was rated to be ‘very good’, ‘good’ or ‘fair’.
Conclusions
Two-stage DS leads to sustained weight loss, resolution of comorbidities and improvement in QoL in carefully selected patients with BMI more than 60 kg/m2.
Description
Citation
Ghosh A, Hussein A, Askari A, Jain V, Adil MT. Resolution of comorbidities and outcomes after revision of sleeve gastrectomy to duodenal switch for patients with body mass index more than 60 kg/m2. Surg Pract. 2023; 27(2): 112-117. doi:10.1111/1744-1633.12615