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Pylorus preserving loop duodeno-enterostomy with sleeve gastrectomy - preliminary results Grueneberger JM; Karcz-Socha I; Marjanovic G; Kuesters S; Zwirska-Korczala K; Schmidt K; Karcz WKBMC Surg 2014[Apr]; 14 (ä): 20BACKGROUND: Bariatric 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. METHODS: 16 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. RESULTS: Mean 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. CONCLUSIONS: Loop duodeno-enterosomies with sleeve gastrectomy can be safely performed and may open new alternatives in bariatric surgery with the possibility for inter-individual adaptation.|Adult[MESH]|Anastomosis, Surgical[MESH]|Bariatric Surgery/*methods[MESH]|Duodenum/*surgery[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Gastrectomy/*methods[MESH]|Humans[MESH]|Ileum/*surgery[MESH]|Jejunum/*surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Obesity, Morbid/surgery[MESH]|Obesity/*surgery[MESH]|Prospective Studies[MESH]|Pylorus/*surgery[MESH]|Treatment Outcome[MESH]|Weight Loss[MESH] |
