14. Laparoskopik Endoskopik Cerrahi Kongresi, Girne, Kıbrıs (Kktc), 19 - 22 Nisan 2019, no.86, ss.93
Weight regain and inadequate co-morbidity reducti on are the most important problems in
the long-term results aft er laparoscopic sleeve gastrectomy(LSG) and in these conditi ons
revisional surgery is considered.Our aim is to show the importance of total small bowel
length and appropriate small bowel loop for determine the lenght of common channel for
the revision of LSG to distal gastric bypass.
Data from the pati ents who underwent measurable one-anastomosis distal gastric
bypass(MOADGB) in the revision of LSG from May 2017 to January 2019 was retrospecti vely
analyzed.In the surgical technique; all pati ents’ small bowel lenght is measured from the
ligament of treitz to ileocecal valve and gastroenterostomy anastomosis was performed
1/3 distal part of the total small bowel length.
Seventeen pati ents(female n=10) with a mean age of 41±2.3 years and a mean BMI of
39.1±1.7kg/m2 were included in the study.The indicati ons for revisional surgery were
inadequate weight loss (n=5), weight regain (n=11) and inadequate co-morbidity reducti on
(n=1).The mean total small bowel length was 10±0.3 meter.The mean operati on ti me was
126.2±5.1 minutes.There was no mortality.Only one pati ent had bleeding(5.8%).Leakage was
observed one pati ent(5.8%). The mean excess weight loss% was 54.1±4.8% aft er the follow-
up period (mean 11.2±1.4 months).The mean values of iron,ferriti n,protein,vitaminB12
and vitaminD were 59.7±5.6ug/dl, 106.7±25.1ng/ml, 6.8±0.1g/dl, 592±57.2pg/ml and
24.9±3.1ng/ml, respecti vely.
In the distal gastric bypass procedure which performed in the revisional surgery aft er LSG,
determining the common canal length by measuring the total small bowel length might
incerease the effi cacy and decrease the rates of complicati ons such as malnutriti on and
vitamin defi ciencies.