THE CALCULATION OF IDEAL BILIOPANCREATIC LIMB LENGTH IN ONE ANASTOMOSIS OR MINI-GASTRIC BYPASS PROCEDURE

Mini gastric bypass procedure and calculation of ideal biliopancreatic limb length

Yazarlar

  • Hasan ergenç hasan_ergenc
  • Erkan Aksoy
  • Zeynep Ergenç
  • Kerim Güzel
  • Feyzi Gökosmanoğlu

DOI:

https://doi.org/10.5281/zenodo.10479134

Anahtar Kelimeler:

One anastomosis or mini-gastric bypass, Small bowel measurement, Ideal biliopancreatic limb length

Özet

ABSTRACT

Objective: Excessive weight loss, malnutrition, and protein malnutrition are considered serious problems in the One Anastomosis or Mini Gastric Bypass (OA-MGB) Procedure. The purpose of the present study was to show whether the Ideal BPL calculated over this length by measuring the length of the small intestine can be a solution to these problems in the 180-200 cm standard BPL.

Methods: A total of 1267 patients who were treated with the OA-MGB method in obesity management were included in the study. The patients were divided into two groups and the length of the small intestine was calculated. One-third of the small intestine was determined as Ideal BPL (Group 1, n=667). Those with BPL 180-200 cm as standard formed group 2 (n=600) without taking into account the length of the small intestine. The patients were followed for 3.4±1.6 years in the study. Weight loss, micronutrients, protein and electrolyte values, clinical and laboratory results, and complications were analyzed in the patients.

Results: In the present study, diarrhea, constipation, malodorous and greasy stool, excessive weight loss, dumping, and protein malnutrition scores were found to be statistically higher in the standard BPL group. The postoperative laboratory markers were statistically significantly higher in the Ideal BPL group than in the standard BPL group (p<0.05) and secondary elevation of parathormone was higher in the standard BPL group.

Conclusion: As a result of the study, nutritional deficiency and protein malnutrition detected in the OA-MGB procedure were not observed in the Ideal BPL group. The study also found that the Ideal BPL length was superior to standard BPL with fewer micronutrient, electrolyte, and protein deficiencies when providing similar weight loss and metabolic remission results.

Keywords: One anastomosis or mini-gastric bypass; Small bowel measurement; Ideal biliopancreatic limb length.

Referanslar

Komaei I, Sarra F, Lazzara C, Ammendola M, Memeo R, Sammarco G, Navarra G, Currò G. One Anastomosis Gastric Bypass-Mini Gastric Bypass with Tailored Biliopancreatic Limb Length Formula Relative to Small Bowel Length: Preliminary Results. Obes Surg. 2019 Sep;29(9):3062-3070. doi: 10.1007/s11695-019-04019-8. PMID: 31209832.

Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001 Jun;11(3):276-80. doi: 10.1381/096089201321336584. PMID: 11433900.

Ramos AC, Chevallier JM, Mahawar K, Brown W, Kow L, White KP, Shikora S; IFSO Consensus Conference Contributors. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study. Obes Surg. 2020 May;30(5):1625-1634. doi: 10.1007/s11695-020-04519-y. PMID: 32152841.

Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK. "Mini" gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013 Nov;23(11):1890-8. doi: 10.1007/s11695-013-1026-8. PMID: 23934271.

Piazza L, Ferrara F, Leanza S, Coco D, Sarvà S, Bellia A, Di Stefano C, Basile F, Biondi A. Laparoscopic mini-gastric bypass: short-term one -institute experience. Updates Surg. 2011 Dec;63(4):239-42. doi: 10.1007/s13304-011-0119-y. Epub 2011 Nov 22. PMID: 22105765.

De Luca M, Tie T, Ooi G, Higa K, Himpens J, Carbajo MA, Mahawar K, Shikora S, Brown WA. Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement. Obes Surg. 2018 May;28(5):1188-1206. doi: 10.1007/s11695-018-3182-3. PMID: 29600339.

Velotti N, Vitiello A, Berardi G, Di Lauro K, Musella M. Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis. Updates Surg. 2021 Apr;73(2):639-647. doi: 10.1007/s13304-020-00938-9. Epub 2021 Feb 19. PMID: 33606148.

Victorzon M. One -anastomosis gastric bypass: better, faster, and safer? Scand J Surg. 2015 Mar;104(1):48-53. doi: 10.1177/1457496914564106. Epub 2014 Dec 10. PMID: 25504663.

Jammu GS, Sharma R. A 7-Year Clinical Audit of 1107 Cases Comparing Sleeve Gastrectomy, Roux-En-Y Gastric Bypass, and Mini-Gastric Bypass, to Determine an Effective and Safe Bariatric and Metabolic Procedure. Obes Surg. 2016 May;26(5):926-32. doi: 10.1007/s11695-015-1869-2. PMID: 26337694.

Kermansaravi M, Pishgahroudsari M, Kabir A, Abdolhosseini MR, Pazouki A. Weight loss after one-anastomosis/mini-gastric bypass - The impact of biliopancreatic limb: A retrospective cohort study. J Res Med Sci. 2020;25:5. Published 2020 Jan 20. doi:10.4103/jrms.JRMS_117_19

Lee WJ, Wang W, Lee YC, Huang MT, Ser KH, Chen JC. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008 Mar;18(3):294-9. doi: 10.1007/s11695-007-9367-9. Epub 2008 Jan 12. PMID: 18193178.

Musella M, Susa A, Greco F, De Luca M, Manno E, Di Stefano C, Milone M, Bonfanti R, Segato G, Antonino A, Piazza L. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014 Jan;28(1):156-63. doi: 10.1007/s00464-013-3141-y. Epub 2013 Aug 28. PMID: 23982648.

Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ. Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2017 May;27(5):1153-1167. doi: 10.1007/s11695-016-2428-1. PMID: 27783366; PMCID: PMC5403902.

Mahawar KK, Kumar P, Parmar C, Graham Y, Carr WR, Jennings N, Schroeder N, Balupuri S, Small PK. Small Bowel Limb Lengths and Roux-en-Y Gastric Bypass: a Systematic Review. Obes Surg. 2016 Mar;26(3):660-71. doi: 10.1007/s11695-016-2050-2. PMID: 26749410.

Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005 Oct;15(9):1304-8. doi: 10.1381/096089205774512663. PMID: 16259892.

Mahawar KK. Yet Another Mortality with a Biliopancreatic Limb of > 200 cm with One Anastomosis Gastric Bypass. Obes Surg. 2018 Nov;28(11):3634-3635. doi: 10.1007/s11695-018-3462-y. PMID: 30105662.

Mahawar KK, Parmar C, Carr WRJ, Jennings N, Schroeder N, Small PK. Impact of biliopancreatic limb length on severe protein-calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Minim Access Surg. 2018 Jan-Mar;14(1):37-43. doi: 10.4103/jmas.JMAS_198_16. PMID: 28695878; PMCID: PMC5749196.

Sam MA, Hussain A, Pegler ME, et al. Effect of one anastomosis gastric bypass on liver function tests: A comparison between 150 cm and 200 cm biliopancreatic limbs. J Minim Access Surg. 2022;18(1):38-44. doi:10.4103/jmas.JMAS_249_20.

Mahawar KK, Carr WR, Balupuri S, Small PK. Controversy surrounding 'mini' gastric bypass. Obes Surg. 2014 Feb;24(2):324-33. doi: 10.1007/s11695-013-1090-0. PMID: 24101089.

Liagre A, Debs T, Kassir R, Ledit A, Juglard G, Chalret du Rieu M, Lazzati A, Martini F, Petrucciani N. One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm: Weight Loss, Nutritional Outcomes, Endoscopic Results, and Quality of Life at 8-Year Follow-Up. Obes Surg. 2020 Nov;30(11):4206-4217. doi: 10.1007/s11695-020-04775-y. Erratum in: Obes Surg. 2021 Jun;31(6):2848. PMID: 32562132.

Yayınlanmış

2023-09-20

Nasıl Atıf Yapılır

ergenç, H., Aksoy, E., Ergenç, Z., Güzel, K., & Gökosmanoğlu, F. (2023). THE CALCULATION OF IDEAL BILIOPANCREATIC LIMB LENGTH IN ONE ANASTOMOSIS OR MINI-GASTRIC BYPASS PROCEDURE: Mini gastric bypass procedure and calculation of ideal biliopancreatic limb length. Journal on Mathematic, Engineering and Natural Sciences (EJONS), 7(3), 454–466. https://doi.org/10.5281/zenodo.10479134