The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience
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2018
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Elsevier
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Surve A, Cottam D, Sanchez-Pernaute A, Torres A, Roller J, Kwon Y, Mourot J, Schniederjan B, Neichoy B, Enochs P, Tyner M, Bruce J, Bovard S, Roslin M, Jawad M, Teixeira A, Srikanth M, Free J, Zaveri H, Pilati D, Bull J, Belnap L, Richards C, Medlin W, Moon R, Cottam A, Sabrudin S, Cottam S, Dhorepatil A. The incidence of complications associated with loop duodeno-ileostomy after single- anastomosis duodenal switch procedures among 1328 patients: a multicenter experience. Surg Obes Relat Dis. 2018 May;14(5):594-601. doi: 10.1016/j.soard.2018.01.020. Epub 2018 Feb 2. PMID: 29530597.
Abstract
Background: The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction.
Objectives: The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures.
Setting: Mixed of private and teaching facilities.
Methods: The medical records of 1328 patients who underwent primary SADS procedure (single-anastomosis duodeno-ileal bypass with sleeve gastrectomy or stomach intestinal pylorus-sparing surgery) by 17 surgeons from 3 countries (United States, Spain, and Australia) at 9 centers over a 6-year period were retrospectively reviewed, and their results were compared with articles in the literature.
Results: Mean preoperative body mass index was 51.6 kg/m(2). Of 1328 patients, 123 patients received a linear stapled duodeno-ileostomy (DI) and 1205 patients a hand-sewn DI. In the overall series, the anastomotic leak, ulcer, and bile reflux occurred in .6% (9/1328), .1% (2/1328), and .1% (2/1328), respectively. None of our patients experienced volvulus at the DI or an internal hernia. Overall, 5 patients (.3%) (3/123 [2.4%] with linear stapled DI versus 2/1205 [.1%] with hand-sewn DI [P < .05]) experienced stricture at the DI in this series.
Conclusions: The overall incidence of complications associated with loop DI was lower than the reported incidence of anastomotic complications after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. SADS procedures may cause much fewer anastomotic complications compared with Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. (C) 2018 American Society for Metabolic and Bariatric Surgery. All rights reserved.