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Laparoscopic Malabsorption Procedures: Postoperative Management and Nutritional Evaluation

  • Dennis Hong
  • Emma J. Patterson

Abstract

Minimally invasive malabsorptive procedures such as the biliopancreatic diversion, developed by Scopinaro et al. (1), and duodenal switch, popularized by Marceau et al. (2) and Hess (3), are effective surgical procedures to produce permanent weight loss. However, they are technically more complex with morbidity and mortality that may exceed those seen with laparoscopic adjustable gastric band or Roux-en-Y gastric bypass (4). In addition, malabsorptive procedures carry a higher risk of nutritional abnormalities such as protein and vitamin deficiencies. Because of higher risks associated with malabsorptive procedures, the postoperative management and nutritional assessment in these patients is a lifelong commitment for both patient and surgeon.

Keywords

Bariatric Surgery Gastric Bypass Continuous Positive Airway Pressure Laparoscopic Adjustable Gastric Band Biliopancreatic Diversion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Scopinaro N, Gianetta E, Friedman D, Adami GF, Traverso E, Bachi V. Evoluation of biliopancreatic bypass. Clin Nutr 1986;137–146.Google Scholar
  2. 2.
    Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998;22:947–954.CrossRefPubMedGoogle Scholar
  3. 3.
    Hess DS. Bilio-pancreatic bypass with a duodenal switch procedure. Obes Surg 1994;4:106(abstr).CrossRefGoogle Scholar
  4. 4.
    Ren C, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 2000;10: 514–523.CrossRefPubMedGoogle Scholar
  5. 5.
    Wu EC, Barba CA. Current practices in the prophylaxis of venous thromboembolism in bariatric surgery. Obes Surg 2000;10(1):7–13.CrossRefPubMedGoogle Scholar
  6. 6.
    Huerta S, Deshields S, Shpiner R, et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. J Gastrointest Surg 2002;6(3):354–358.CrossRefPubMedGoogle Scholar
  7. 7.
    Huerta S, Arteaga JR, Sawicki MP, et al. Assessment of routine elimination of postoperative nasogastric decompression after Roux-en-Y gastric bypass. Surgery 2002; 132(5):844–848.CrossRefPubMedGoogle Scholar
  8. 8.
    Serafini F, Anderson W, Ghassemi P, et al. The utility of contrast studies and drains in the management of patients after Roux-en-Y gastric bypass. Obes Surg 2002;12(1):34–38.CrossRefPubMedGoogle Scholar
  9. 9.
    Toppino M, Cesarani F, Comba A, et al. The role of early radiological studies after gastric bariatric surgery. Obes Surg 2001;11(4):447–454.CrossRefPubMedGoogle Scholar
  10. 10.
    Sims TL, Mullican MA, Hamilton EC, et al. Routine upper gastrointestinal Gastrografin swallow after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003;13(1): 66–72.CrossRefPubMedGoogle Scholar
  11. 11.
    Singh R, Fisher BL. Sensitivity and specificity of postoperative upper GI series following gastric bypass. Obes Surg 2003;13(1):73–75.CrossRefPubMedGoogle Scholar
  12. 12.
    Marceau P, Hould FS, Lebel S, et al. Malabsorptive Obesity Surgery. Surg Clin North Am 2001;81(5):1113–1127.CrossRefPubMedGoogle Scholar
  13. 13.
    Brolin RE, LaMarca LB, Kenler HA, Cody RP. Malabsorptive Gastric Bypass in patients with superobesity. J Gastrointest Surg 2002;6:195–205.CrossRefPubMedGoogle Scholar
  14. 14.
    Baltasar A, del Rio J, Escriva C, et al. Preliminary results of the duodenal switch. Obes Surg 1997;7;500–504.CrossRefPubMedGoogle Scholar
  15. 15.
    Scopinaro N, Gianetta E, Adami GF, et al. Biliopancreatic diversion for obesity at eighteen years. Surgery 1996;119: 261–268.CrossRefPubMedGoogle Scholar
  16. 16.
    Scopinaro N, Marinari GM, Camerini G, et al. Energy and nitrogen absorption after Biliopancreatic diversion. Obes Surg 2000;10:436–441.CrossRefPubMedGoogle Scholar
  17. 17.
    Baltasar A, Bou R, Bengochea M, et al. Duodenal switch: an effective therapy for morbid obesity-intermediate results. Obes Surg 2001;11:54–58.CrossRefPubMedGoogle Scholar
  18. 18.
    Marceau P, Biron S, Lebel S, et al. Does bone change after biliopancreatic diversion? J Gastrointest Surg 2002;6:690–698.CrossRefPubMedGoogle Scholar
  19. 19.
    Adamama-Moraitou K, Rallis T, Papasteriadis A, et al. Iron, zinc and copper concentration in serum, various organs, and hair of dogs with experimentally induced exocrine pancreatic insufficiency. Dig Dis Sci 2001;46(7):1444–1457.CrossRefPubMedGoogle Scholar
  20. 20.
    Vanderhoof JA, Scopinaro N, Tuma DJ, et al. Hair and plasma zinc levels following exclusion of biliopancreatic secretions from functioning gastrointestinal tract in humans. Dig Disc Sci 1983;29(4):300–305.CrossRefGoogle Scholar
  21. 21.
    Primavera A, Brusa G, Novello P, et al. Wernicke-Korsakoff Encephalopathy following biliop ancre atic diversion. Obes Surg 1993;3(2):175–177.CrossRefPubMedGoogle Scholar
  22. 22.
    Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg 1999;9:150–154.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Dennis Hong
    • 1
  • Emma J. Patterson
    • 2
  1. 1.Department of SurgeryGood Samaritan HospitalPortlandUSA
  2. 2.Bariatric Surgery Program, Department of SurgeryLegacy Health SystemPortlandUSA

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