Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus.

Autor: Kermansaravi M; Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com., Chiappetta S; Department of General and Laparoscopic Surgery, Bariatric and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy. drschiappetta@gmail.com., Parmar C; Whittington Hospital, London, UK., Carbajo MA; Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain., Musella M; Advanced Biomedical Sciences Department, 'Federico II' University, Naples, Italy., Chevallier JM; Université Paris 5, Paris, France., Ribeiro R; Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora e Lisboa, Amadora, Portugal., Ramos AC; Gastro-Obeso-Center, Institute for Metabolic Optimization, Sao Paulo, Brazil., Weiner R; Bariatric Surgery Unit, Sana Clinic Offenbach, Offenbach, Germany., Nimeri A; Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA., Aarts E; WeightWorks Clinics and Allurion Clinics, Amersfoort, The Netherlands., Abbas SI; Iranian Hospital, Alwasl Road, Dubai, UAE., Bashir A; Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan., Behrens E; New Life Center, Guatemala, Guatemala., Billy H; Ventura Advanced Surgical Associates, Ventura, CA, USA., Cohen RV; Center for the Treatment of Obesity and Diabetes, Oswaldo Cruz German Hospital, Sao Paolo, Brazil., Caina D; Dr. Federico Abete Hospital for Trauma and Emergency, Obesity and Metabolic Center, Malvinas, Argentina., De Luca M; Department of General Surgery, Rovigo Hospital, Rovigo, Italy., Dillemans B; Department of General Surgery, AZ Sint Jan Brugge-Oostende, Brugge, Belgium., Fobi MAL; Mohak Bariatrics and Robotics Surgery Center, Indore, India., Neto MG; Mohak Bariatric and Robotic Center, Indore, India., Gawdat K; Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt., ElFawal MH; Makassed General Hospital, Beirut, Lebanon., Kasama K; Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan., Kassir R; Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France., Khan A; Walsall Healthcare NHS Trust, Walsall, UK., Kow L; Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia., Kular KDS; Founding President MGB-OAGB Club, Kular Research Institute, Bija, India., Lakdawala M; Sir H N Reliance Foundation Hospital, Mumbai, India., Layani L; Al Sharq Hospital, Fujairah, UAE., Lee WJ; Medical Weight Loss Center, China Medical University Shinchu Hospital, Zhubei, Taiwan., Luque-de-León E; The American British Cowdray Medical Center, Mexico City, Mexico., Mahawar K; South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK., Almomani H; NMC Royal Hospital, Abu Dhabi, UAE., Miller K; Diakonissen Wehrle Private Hospital, Salzburg, Austria., González JCO; Obesity Surgeons Mexico, Reynosa, Tamaulipas, Mexico., Prasad A; Apollo Hospital New Delhi, New Delhi, India., Rheinwalt K; Department of Bariatric, Metabolic, and Plastic Surgery, St. Franziskus Hospital, Cologne, Germany., Rutledge R; Center for Laparoscopic Obesity Surgery, Las Vegas, NV, USA., Safadi B; Aman Hospital, Doha, Qatar., Salminen P; Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Turku, Finland., Shabbir A; National University of Singapore, Singapore, Singapore., Taskin HE; Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey., Verboonen JS; Obesity Goodbye Center, Tijuana, Mexico., Vilallonga R; Endocrine, Bariatric, and Metabolic Surgery Department, University Hospital Vall Hebron, Barcelona, Spain., Wang C; Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China., Shikora SA; Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA., Prager G; Medical University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2024 Jul; Vol. 34 (7), pp. 2399-2410. Date of Electronic Publication: 2024 Jun 11.
DOI: 10.1007/s11695-024-07345-8
Abstrakt: Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.
Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.
Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300-400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB.
Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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