Abstract
A side-to-side duodeno-ileostomy, or “duodenal bipartition,” is a modification of the single anastomosis duodeno-ileostomy (SADI), a much less complicated anastomosis. Compared to the SADI, the duodenal transection is easier to perform and produces fewer nutritional complications. When performed as a second-stage procedure for weight regain, inadequate weight loss, and/or recurrence of type 2 diabetes, the duodenal bipartition contributes an extra 40% of excess weight loss after sleeve gastrectomy. This chapter describes one of the available anastomotic sites, the infracolic or transmesocolic approach, although the antecolic anastomosis can also be performed.
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References
Chu C, Gagner M, Quinn T, Voellinger DC, Feng JJ, Inabnet WB, Herron D, Pomp A. Two-stage laparoscopic BPD/DS. An alternative approach to super-super morbid obesity. Surg Endosc. 2002:S187.
Lazzati A, Bechet S, Jouma S, Paolino L, Jung C. Revision surgery after sleeve gastrectomy: a nationwide study with 10 years of follow-up. Surg Obes Relat Dis. 2020;16(10):1497–504.
Clapp B, Dodoo C, Harper B, Kim J, Castro C, Hamdan M, Grasso S, Davis B. Magnetic sphincter augmentation at the time of bariatric surgery: an analysis of the MBSAQIP. Surg Obes Relat Dis. 2021;17(3):555–61.
Dijkhorst PJ, Boerboom AB, Janssen IMC, Swank DJ, Wiezer RMJ, Hazebroek EJ, Berends FJ, Aarts EO. Failed sleeve gastrectomy: single anastomosis Duodenoileal bypass or roux-en-Y gastric bypass? A multicenter cohort study. Obes Surg. 2018;28(12):3834–42.
Sánchez-Pernaute A, Rubio MÁ, Conde M, Arrue E, Pérez-Aguirre E, Torres A. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–7.
Del Genio G, Gagner M, Cuenca-Abente F, Nocca D, Biertho L, Del Genio F, Assalia A, Del Genio A. Laparoscopic sleeve gastrectomy with duodeno-jejunal bypass: a new surgical procedure for weight control. Feasibility and safety study in a porcine model. Obes Surg. 2008;18(10):1263–7.
Gagner M. Hypoabsorptive surgery is the best revisional strategy for metabolic and diabetes outcomes. Surg Obes Relat Dis. 2020;16(10):1454–5.
Strain GW, Torghabeh MH, Gagner M, Ebel F, Dakin GF, Abelson JS, Connolly D, Pomp A. The impact of biliopancreatic diversion with duodenal switch (BPD/DS) over 9 years. Obes Surg. 2017;27(3):787–94.
Santoro S, Castro LC, Velhote MC, Malzoni CE, Klajner S, Castro LP, Lacombe A, Santo MA. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10.
Mahdy T, Gado W, Alwahidi A, Schou C, Emile SH. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg. 2021;31(4):1579–89.
Gagner M. Safety and efficacy of a side-to-side duodeno-ileal anastomosis for weight loss and type-2 diabetes: duodenal bipartition, a novel metabolic surgery procedure. Ann Surg Innov Res. 2015;9:6.
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;14(5):594–601.
Gagner M. Side-to-side duodeno-colic anastomosis provides dramatic weight loss. A potentially strong anti-diabetic operation for type-2 diabetes. Minerva Chir. 2017;72(3):169–77.
Gagner M. Emerging Techniques in Bariatric Surgery - Laparoscopic Duodeno-Ileostomy. ACS-2771 Online video Library of the American College of Surgeons. 2009.
Gagner M. Chapter 10: Bipartición duodenoileal con anastomosis laterolateral. In: Palermo M, González AR, editors. In Atlas de Cirugia Bariatrica y Metabolica. Abordaje Laparoscópico, Endoscópico y Técnicas Miniinvasivas + Acceso a Contenidos Online. Palo Alto California, Amolca Publisher; 2018.
Gagner M. Laparoendoscopic magnetic gastrointestinal anastomosis. Chapter 14. In: Gagner M, editor. Magnetic surgery. New York, NY: Springer; 2021.
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Gagner, M., Lapointe-Gagner, M. (2023). Duodenal Bipartition or Side-to-Side Duodeno-Ileostomy: Rationale and Technical Details. In: Teixeira, A., et al. Duodenal Switch and Its Derivatives in Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-25828-2_27
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DOI: https://doi.org/10.1007/978-3-031-25828-2_27
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