| Title |
Laparoscopic reversal of mini-gastric bypass to original anatomy for severe postoperative malnutrition
|
|---|---|
| Published in |
Langenbeck's Archives of Surgery, August 2017
|
| DOI | 10.1007/s00423-017-1615-4 |
| Pubmed ID | |
| Authors |
Laurent Genser, Antoine Soprani, Malek Tabbara, Jean-Michel Siksik, Jean Cady, Sergio Carandina |
| Abstract |
Malnutrition after mini-gastric bypass (MGB) is a rare and dreaded complication with few data available regarding its surgical management. We aim to report the feasibility, safety, and results of laparoscopic reversal of MGB to normal anatomy (RMGB) in case of severe and refractory malnutrition syndrome after intensive nutritional support (SRMS). A 10-year retrospective chart review was performed on patients who underwent RMGB (video included) for SRMS following MGB. Twenty-six of 2934 patients underwent a RMGB at a mean delay of 20.9 ± 13.4 months post-MGB. At presentation, mean body mass index (BMI), excess weight loss (%EWL), and albumin serum level were 22 ± 4.4 kg/m(2), 103.6 ± 22.5%, and 25.5 ± 3.6 gr/L, respectively. Seventeen (63.5%) patients had at least one severe malnutrition related complication including severe edema in 13 (50%), venous ulcers in 2 (7.7%), infectious complications in 7 (27%), deep venous thrombosis in 5 (19.2%), and motor deficit in 5 (19.2%) patients. At surgical exploration, 8 of 12 (66.5%) patients had a biliary limb longer than 200 cm and 9 (34.6%) had bile reflux symptoms. Overall morbidity was 30.8% but lower when resecting the entire previous gastrojejunostomy with creation of a new jejunojejunostomy (8.3 vs 50%, p = 0.03). After a mean follow-up of 8 ± 9.7 months, all patients experienced a complete clinical and biological regression of the SRMS after the RMGB despite a mean 13.9 kg weight regain in 16 (61.5%) patients. Post-MGB SRMS and its related comorbidities are rare but dreaded conditions. Although burdened by a significant postoperative morbidity and weight regain, RMGB remains an effective option to consider, when intensive nutritional support fails. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Kuwait | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 65 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 8 | 12% |
| Other | 7 | 11% |
| Student > Bachelor | 6 | 9% |
| Student > Master | 6 | 9% |
| Researcher | 6 | 9% |
| Other | 12 | 18% |
| Unknown | 20 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 31 | 48% |
| Unspecified | 4 | 6% |
| Nursing and Health Professions | 3 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Environmental Science | 1 | 2% |
| Other | 4 | 6% |
| Unknown | 21 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2017.
All research outputs
#15,867,545
of 23,577,654 outputs
Outputs from Langenbeck's Archives of Surgery
#665
of 1,173 outputs
Outputs of similar age
#201,409
of 319,702 outputs
Outputs of similar age from Langenbeck's Archives of Surgery
#8
of 13 outputs
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