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Dumping-Syndrom

Diagnostik und Therapieoptionen

Dumping syndrome

Diagnostics and therapeutic options

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Zusammenfassung

Hintergrund

Das Dumping-Syndrom ist ein häufiges Phänomen nach Chirurgie des oberen Gastrointestinaltrakts. Die Bandbreite der Symptome umfasst milde gastrointestinale Beschwerden, über moderate vasomotorische Störungen bis hin zu schweren hyperinsulinämen Hypoglykämien. Durch die weltweit stetig steigende Zahl bariatrischer Operationen ist die bariatrische Chirurgie mittlerweile der häufigste Grund dieser Krankheitsentität.

Zielsetzung

In diesem Review soll die vorhandene Datenlage zum Dumping-Syndrom nach bariatrischer Chirurgie – insbesondere nach Roux-en-Y-Magenbypass und Magenschlauchbildung (Sleeve) – unter besonderer Berücksichtigung der dafür spezifischen Pathophysiologie, etwaiger Vermeidungsstrategien im Sinne operationstaktischer Überlegungen und Patientenselektion, Differenzialdiagnose und gradueller Diagnostik sowie möglicher Therapieoptionen dargestellt und diskutiert werden.

Abstract

Background

Dumping syndrome is a common complication after surgery of the upper gastrointestinal tract with symptoms ranging from mild gastrointestinal discomfort and moderate vasomotor disturbances, to severe hyperinsulinemic hypoglycemia. Due to the increasing number of bariatric procedures being performed worldwide, bariatric surgery has become the most common cause for this disease entity.

Objective

The aim of this review is to highlight the evidence for the physiological mechanisms contributing to dumping syndrome after the two most common bariatric surgery procedures, Roux-en-Y gastric bypass and sleeve gastrectomy, to discuss technical aspects of the procedures underlying the development of the syndrome, patient-related predictive factors and other differential diagnoses, together with diagnostic and therapeutic algorithms.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemein- und Viszeral-, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland

    F. Seyfried, A. Wierlemann & C. Jurowich

  2. Medizinische Klinik und Poliklinik I, Universitätsklinikum Würzburg, Würzburg, Deutschland

    M. Bala & M. Fassnacht

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  1. F. Seyfried
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  2. A. Wierlemann
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Correspondence to F. Seyfried.

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Seyfried, F., Wierlemann, A., Bala, M. et al. Dumping-Syndrom. Chirurg 86, 847–854 (2015). https://doi.org/10.1007/s00104-015-0047-3

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