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Re-sleeve gastrectomie

Laparoscopic sleeve gastrectomy

  • Article Original / Original Article
  • Published:
Obésité

Résumé

Situation

La gastrectomie longitudinale ou sleeve gastrectomie (SG) est de plus en plus choisie comme traitement chirurgical de l’obésité morbide. Cela en raison de son efficacité et de son taux acceptable de complications. À long terme, la dilatation de la poche gastrique peut entraîner une stagnation de la perte de poids et une reprise pondérale.

Méthode

Nous rapportons un cas de SG réalisée chez un homme de 19 ans, porteur d’un situs inversus complet, et d’une super-superobésité morbide (IMC > 60 kg/m2). Son poids était de 226 kg avec un IMC à 76 kg/m2. Dix-huit mois après l’intervention, son poids était de 170 kg avec un IMC à 57 kg/m2 (%PEP: 37 %). Un transit œsogastroduodénal alors effectué a montré une dilatation de la poche gastrique. Nous avons décidé de réaliser une re-sleeve gastrectomie par laparoscopie (RSG).

Résultats

Trente-huit mois après la RSG, le patient pesait 81 kg avec un IMC à 27 kg/m2 (%PEP: 96 %). L’association SG plus RSG a permis une perte de poids de 145 kg. Lors du suivi de 58 mois, aucune complication n’a été constatée. Conclusion: La RSG après SG doit avoir une place dans l’approche thérapeutique de l’obésité morbide en cas de dilatation secondaire ou de poche gastrique initiale trop volumineuse.

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) has become popular in the morbidly obese patient because of its effectiveness and low complication rate. The main concern in isolated LSG is the possibility of dilatation of the gastric pouch and long term weight regain.

Methods

We report a case of LSG performed on a 19-year-old patient with situs inversus totalis and super-superobesity. His weight was 226 kg with a BMI of 76 kg/m2. Eighteen months after LSG, the patient’s weight became 170 kg with a BMI of 57 kg/m (%EWL: 37%). An upper gastro-intestinal contrast study showed a dilatation of the gastric pouch. Two months later, we performed a re-laparoscopic sleeve gastrectomy (RLSG).

Results

Thirty-eight months after RLSG, the patient’s weight became 81 kg with a BMI of 27 kg/m2 (%EWL: 96%). During the 58 months follow-up period, no complications were noted. Conclusion: RLSG should be considered for treatment of morbid obesity if the gastric pouch becomes too large or dilated after LSG.

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Authors and Affiliations

  1. Service de chirurgie viscérale, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, F-93205, Saint-Denis cedex, France

    J. -M. Catheline

  2. Service de chirurgie viscérale, centre hospitalier de Saint-Denis, F-93200, Saint-Denis, France

    J. -M. Catheline, R. Dbouk, N. Helmy & I. Ruzeykin

  3. Service d’endocrinologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, F-93000, Bobigny, France

    R. Cohen, H. Bihan & G. Reach

Authors
  1. J. -M. Catheline
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  2. R. Dbouk
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  3. N. Helmy
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  4. I. Ruzeykin
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  5. R. Cohen
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  6. H. Bihan
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  7. G. Reach
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Correspondence to J. -M. Catheline.

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Catheline, J.M., Dbouk, R., Helmy, N. et al. Re-sleeve gastrectomie. Obes 6, 123–125 (2011). https://doi.org/10.1007/s11690-011-0260-2

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  • DOI: https://doi.org/10.1007/s11690-011-0260-2

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