Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigs

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
John de CsepelMichel Gagner

Abstract

Biliopancreatic diversion with a duodenal switch is an emerging open procedure that appears as effective as other bariatric operations. Our goal was to determine the safety and feasibility of performing this procedure using a laparoscopic approach in a porcine model. Six 50-kg pigs underwent surgery. Intake was restricted with a sleeve gastrectomy, and malabsorption was obtained by creating a Roux-en-Y. The Roux limb served as a 150-cm alimentary channel following anastomosis to a transected proximal duodenum, while the other limb, or biliopancreatic channel, transported digestive juices. Where the two limbs joined, a 100-cm common channel was formed. The operation was completed in a mean time of 4.5 hours. Two of the six pigs had an intraoperative duodenoenterostomy anastomotic leak detected on methylene blue testing. This leakage was thought to be related to pig anatomy and is not expected to be a problem in humans. At necropsy, all anastomoses were patent, and there were no enteroenterostomy leaks or mesenteric torsions. On the basis of the porcine model, laparoscopic biliopancreatic diversion with a duodenal switch is anticipated to be feasible and safe in humans. Substantial weight loss combined with the benefits of laparo...Continue Reading

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Citations

Jan 7, 2009·Surgical Endoscopy·Timothy M FarrellRobert D Fanelli
Sep 27, 2007·Obesity Surgery·Andrew A GumbsAlfons Pomp
Dec 13, 2007·Obesity Surgery·Andrew A GumbsMichel Gagner
Sep 25, 2002·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·John de CsepelMichel Gagner
Oct 9, 2013·Obesity Surgery·Kamal K MahawarPeter K Small
Jan 1, 2013·Gastroenterology Research and Practice·Blaire AndersonMichel Gagner
May 23, 2009·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·UNKNOWN SAGES Guidelines Committee
Dec 28, 2004·The Surgical Clinics of North America·Michel Gagner, Ronald Matteotti
Dec 23, 2014·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Rojbin KarakoyunHakan Gülkesen
Oct 22, 2008·Annals of Surgery·Henry BuchwaldSayeed Ikramuddin
Feb 9, 2010·Expert Review of Gastroenterology & Hepatology·Wasef Abu-Jaish, Raul J Rosenthal
Sep 16, 2008·Surgical Endoscopy·UNKNOWN SAGES Guidelines Committee
Sep 12, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·C Stier, C Corteville
Mar 22, 2021·The Surgical Clinics of North America·Kevin Climaco, Eric Ahnfeldt

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