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. 2023 Dec;37(12):9310-9317.
doi: 10.1007/s00464-023-10505-z. Epub 2023 Oct 26.

The use of a total bowel length measurement protocol may reduce reoperations and complications after single-anastomosis duodenal switch

Lucas Fair  1   2 , Anthony C Waddimba  1   2 , Phillip Strothman  1 , Darby Dwyer  3 , Priscilla Anderton  3 , Anella Bittle  2 , Gerald O Ogola  2 , Steven Leeds  1   3   4 , Daniel Davis  5   6   7   8
Affiliations

The use of a total bowel length measurement protocol may reduce reoperations and complications after single-anastomosis duodenal switch

Lucas Fair et al. Surg Endosc. 2023 Dec.

Abstract

Introduction: Most surgeons who perform single-anastomosis duodeno-ileal switches (SADI-S) use a pre-determined common channel length without measuring total bowel length (TBL). However, TBL varies between patients, and a standardized common channel length could contribute to malabsorptive complications and reoperations following SADI-S. The purpose of this study was to determine whether using a TBL measurement protocol to individualize common channel length would be associated with reduced reoperations and complications.

Methods: A prospectively maintained data registry was retrospectively reviewed to identify all patients who underwent SADI-S between September 2017 and February 2022. In April 2021, we began using TBL measurements during SADI-S with 40% of the TBL used as the length for the common channel. Outcomes pre-TBL and post-TBL measurement protocol were compared.

Results: A total of 119 SADI-S recipients (59 pre-TBL; 60 post-TBL) were included. The pre-TBL group had a higher frequency of reoperations (23.7% vs 1.7%, p < 0.001) and late complications (29.3% vs 3.3%, p < 0.001). The mean time to reoperation was 13.7 months in the pre-TBL group and 6.7 months in the post-TBL group (p = 0.347). Patients in the post-TBL group had significantly higher serum albumin levels at 3 months (4.2 g/dL vs 3.5 g/dL, p < 0.001), 6 months (4.1 g/dL vs 3.6 g/dL, p < 0.001), and 12 months (4.2 g/dL vs 3.8 g/dL, p = 0.023) postoperatively when compared to the pre-TBL group.

Conclusion: Using TBL measurements to individualize common channel length was associated with a significant reduction in reoperations and late complications following SADI-S.

Keywords: Common channel; Complications; Duodenal switch; Malnutrition; Single-anastomosis duodeno-ileal switch (SADI-S); Total bowel length.

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References

    1. Centers for Disease Control and Prevention (2022) Adult obesity facts. https://www.cdc.gov/obesity/data/adult.html#print . Accessed 27 Feb 2023
    1. Cosentino C, Marchetti C, Monami M, Mannucci E, Cresci B (2021) Efficacy and effects of bariatric surgery in the treatment of obesity: network meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 31(10):2815–2824 - DOI
    1. Wang L, Lin M, Yu J et al (2021) The impact of bariatric surgery versus non-surgical treatment on blood pressure: systematic review and meta-analysis. Obes Surg 31(11):4970–4984 - DOI
    1. Khorgami Z, Shoar S, Saber AA et al (2019) Outcomes of bariatric surgery versus medical management for type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Obes Surg 29(3):964–974 - DOI
    1. Susstrunk J, Schneider R, Peterli R et al (2023) Long-term outcome after biliopancreatic diversion with duodenal switch: a single-center experience with up to 20 years follow-up. Surg Obes Relat Dis 19(2):83–90 - DOI

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