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. 2024 Aug;34(8):2880-2887.
doi: 10.1007/s11695-024-07322-1. Epub 2024 Jun 14.

Proximal Jejuno-Ileal Bypass as Revision of Roux-en-Y Gastric Bypass

José Pablo Vélez Londoño  1 , Aura María Salazar Solarte  2   3 , Diego Fernando Toro Arana  1 , Sara Guerrero Forero  1 , Andrés Felipe Ortiz Restrepo  1 , Alin Abreu Lomba  4 , Wilfredo Antonio Rivera Martínez  5
Affiliations

Proximal Jejuno-Ileal Bypass as Revision of Roux-en-Y Gastric Bypass

José Pablo Vélez Londoño et al. Obes Surg. 2024 Aug.

Abstract

Introduction: Bariatric surgery is established as a possibility for the treatment of obesity, allowing weight reduction and remission of obesity comorbidities. Reported suboptimal clinical response rates are as high as 30-60% (insufficient weight loss or gain, defined as BMI greater than 35 kg/m2 or excess weight loss less than 50%). Proximal jejuno-ileal bypass (PJIBP) is a promising option when re-intervention is required.

Objectives: To describe the standardization of a proprietary technique of modified PJIBP as a management procedure in patients with post-gastric bypass recurrent weight gain or insufficient post-intervention weight loss.

Methods: This study evaluated a case series of 10 Latin American patients requiring post-bariatric re-intervention, between February 2018 and 2023, in a single-metabolic surgery center in Cali-Colombia.

Results: Median age was 45 years (26-70 RIC), 60% female, and 40% male. Mean BMI at conversion was 36.7 kg/m2 (6.4 SD). Median follow-up was 22 months (RIC 16-30). Mean percentage of excess weight lost was 78% (22.4 SD). One hundred percent achieved glycemia control, only one patient persisted with dyslipidemia, and no patient presented hypoalbuminemia. At the end of follow-up, 100% received vitamin supplementation.

Conclusion: PJIBP could be an effective procedure, associated with positive results in relation to weight loss and resolution of obesity comorbidities. Deficiencies of fat-soluble vitamins and protein malnutrition represent the main concern in the long term, so multidisciplinary management and continuous follow-up are required.

Keywords: Metabolic surgery; Obesity; Proximal jejuno-ileal bypass surgery; Roux-en-Y gastric bypass.

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References

    1. Hu FB, Matsuzawa Y, Loos RJF, et al. Obesity Nat Rev Dis Primers. 2017;3:17034. - DOI - PubMed
    1. Risk NCD, Collaboration F. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. 2014;387(10026):1377–96.
    1. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019;15:288–98. - DOI - PubMed
    1. Duque AP, Junior LFR, Mediano MFF, et al. Emerging concepts in metabolically healthy obesity. Am J Cardiovasc Dis. 2020;10(2):48–61.
    1. Hruby A, Hu FB. The Epidemiology of obesity: a big picture. Pharmacoeconomics. 2015;33(7):673–89.