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Reversing One-Anastomosis Gastric Bypass Surgery due to Severe and Refractory Hypoalbuminemia

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Abstract

Background

Laparoscopic one-anastomosis gastric bypass (LOAGB) has to be reverse under some circumstances. This study is aimed to introduce and review a series of LOAGB cases that had to be reversed to normal anatomy due to severe hypoalbuminemia and its related symptoms after a few months.

Methods

Patients who had LOAGB from 2014 to 2018 and then reversed after some months were included in this study. Their first and second surgical data were collected and reviewed for important and relevant information.

Results

From 846 cases of LOAGB, 12 patients reversed after a mean of 12.1 months. All of them were women with mean age of 46 years. All of the gastrojejunostomy anastomosis had been made 200 cm after the Treitz ligament, and all of the patients had at least 250 cm common channel. The mean excess body mass index loss before the reversal surgery was 107.7%. None patients lost or died during the study.

Conclusion

Regarding anastomosis, 200 cm from Treitz ligament is not suitable for all of the patients and common channel more than 250 cm cannot prevent hypoalbuminemia. The surgeon should decide as quickly as possible whether his/her patients need reversal surgery or not. Appropriate patients should be selected for LOAGB.

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Acknowledgements

We express our gratitude toward Mr. Amir Salar Moazen Safaei for his nice and kind support through this research.

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Authors and Affiliations

  1. Isfahan Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, Isfahan University of Medical Sciences, Sofe Blvd, Isfahan, Iran

    Behrouz Keleidari, Mohsen Mahmoudieh, Shahab Shahabi, Mohammadtaghi Rezaei & Masoud Sayadi

  2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Erfan Sheikhbahaei

  3. Isfahan Minimally Invasive Surgery and Obesity Research Center, Amin University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

    Hamid Melali

Authors
  1. Behrouz Keleidari
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  2. Mohsen Mahmoudieh
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  3. Shahab Shahabi
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  4. Erfan Sheikhbahaei
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  5. Mohammadtaghi Rezaei
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  6. Masoud Sayadi
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  7. Hamid Melali
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Corresponding author

Correspondence to Shahab Shahabi.

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Conflict of interest

The authors declare no potential conflict of interests.

Ethical approval

This study commenced after receiving its ethical approval from research department of Isfahan University of Medical Sciences under the code “IR.MUI.MED.REC.1397.302.” The study conducted under ethical Declaration of Helsinki.

Informed consent

An informed written consent was obtained from all of the patients before each surgery.

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Keleidari, B., Mahmoudieh, M., Shahabi, S. et al. Reversing One-Anastomosis Gastric Bypass Surgery due to Severe and Refractory Hypoalbuminemia. World J Surg 44, 1200–1208 (2020). https://doi.org/10.1007/s00268-019-05290-7

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  • DOI: https://doi.org/10.1007/s00268-019-05290-7

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