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Obésité

, 6:123 | Cite as

Re-sleeve gastrectomie

  • J. -M. CathelineEmail author
  • R. Dbouk
  • N. Helmy
  • I. Ruzeykin
  • R. Cohen
  • H. Bihan
  • G. Reach
Article Original / Original Article
  • 55 Downloads

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.

Mots clés

Obésité morbide Chirurgie bariatrique Sleeve gastrectomie Re-sleeve gastrectomie Situs inversus 

Laparoscopic sleeve gastrectomy

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.

Keywords

Morbid obesity Bariatric surgery Sleeve gastrectomy Re-sleeve gastrectomy Situs inversus 

Références

  1. 1.
    Regan JP, Inabnet WB, Gagner M, et al (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-superobese patient. Obes Surg 13:861–864PubMedCrossRefGoogle Scholar
  2. 2.
    Almogy G, Crookes PF, Anthone GJ (2004) Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg 14:492–497PubMedCrossRefGoogle Scholar
  3. 3.
    Fazylov RM, Savel RH, Horovitz JH, et al (2005) Association of super-superobesity and male gender with elevatued mortality in patients undergoing the duodenal switch procedure. Obes Surg 15:618–623PubMedCrossRefGoogle Scholar
  4. 4.
    Consten EC, Gagner M, Pomp A, et al (2004) Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg 14:1360–1366PubMedCrossRefGoogle Scholar
  5. 5.
    Buchwald H, Williams SE (2004) Bariatric surgery worldwide 2003. Obes Surg 14:1157–1164PubMedCrossRefGoogle Scholar
  6. 6.
    Deitel M, Crosby RD, Gagner M (2008) The first international consensus summit for sleeve gastrectomy, New York City, October 25–27, 2007. Obes Surg 18:487–496PubMedCrossRefGoogle Scholar
  7. 7.
    Sabbagh C, Verhaeghe P, Dhari A, et al (2010) Two year results on morbidity, weight loss and quality of life of sleeve gastrectomy as first procédure, sleeve gastrectomy after failure of gastric banding. Obes Surg 20:679–684PubMedCrossRefGoogle Scholar
  8. 8.
    Baltasar A, Serra C, Pérez N, et al (2006) Re-sleeve gastrectomy. Obes Surg 16:1535–1538PubMedCrossRefGoogle Scholar
  9. 9.
    Catheline JM, Rosales C, Cohen R, et al (2006) Laparoscopic sleeve gastrectomy for a super-superobese patient with situs inversus totalis. Obes Surg 16:1092–1095PubMedCrossRefGoogle Scholar
  10. 10.
    Catheline JM (2010) Re-sleeve gastrectomy for super-superobesity with situs inversus. http//www-smbh.univ-paris13.fr/smbh/pedago/mediatheque/videos/multi_film115.html
  11. 11.
    Langer FB, Reza-Hoda MA, Bohdjalian A, et al (2005) Sleeve gastrectomy and gastric banding: effects on plasma Ghrelin levels. Obes Surg 15:1024–1029PubMedCrossRefGoogle Scholar
  12. 12.
    Cohen R, Uzzan B, Bihan H, et al (2005) Ghrelin levels and sleeve gastrectomy in super-superobesity. Obes Surg 15:1501–1502PubMedCrossRefGoogle Scholar
  13. 13.
    Uzzan B, Catheline JM, Lagorce C, et al (2007) Expression of ghrelin in fundus is increased after gastric banding in morbidly obese patients. Obes Surg 17:1159–1164PubMedCrossRefGoogle Scholar
  14. 14.
    Himpens J, Dapri G, Cadière GB (2006) A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16:1450–1456PubMedCrossRefGoogle Scholar
  15. 15.
    Milone L, Strong V, Gagner M (2005) Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric ballon as a first stage procedure for the super-superobese patient. Obes Surg 15:612–617PubMedCrossRefGoogle Scholar
  16. 16.
    Baltasar A, Serra C, Perez N, et al (2005) Laparoscopic sleeve gastrectomy: an operation with multiple indications. Obes Surg 15:1124–1128PubMedCrossRefGoogle Scholar
  17. 17.
    Mognol P, Chosidow D, Marmuse JP (2005) Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg 15:1030–1033PubMedCrossRefGoogle Scholar
  18. 18.
    Gagner M (2010) Leaks after sleeve gastrectomy are associated with smaller bougies: prevention and treatment stratégies. Surg Laparosc Endosc Percutan Tech 20:166–169PubMedCrossRefGoogle Scholar
  19. 19.
    Jossart GH (2010) Complications of sleeve gastrectomy: bleeding and prevention. Surg Laparosc Endosc Percutan Tech 20:146–147PubMedCrossRefGoogle Scholar
  20. 20.
    Langer FB, Shakeri-Leidenmuhler S, Bohdjalian A, et al (2010) Strategies for weight regain after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech 20:159–161PubMedCrossRefGoogle Scholar
  21. 21.
    Gagner M, Rogula T (2003) Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg 13:649–654PubMedCrossRefGoogle Scholar
  22. 22.
    Langer FB, Bohjalian A, Felberbaure F, et al (2006) Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity. Obes Surg 16:166–171PubMedCrossRefGoogle Scholar

Copyright information

© Springer Paris 2011

Authors and Affiliations

  • J. -M. Catheline
    • 1
    • 2
    Email author
  • R. Dbouk
    • 2
  • N. Helmy
    • 2
  • I. Ruzeykin
    • 2
  • R. Cohen
    • 3
  • H. Bihan
    • 3
  • G. Reach
    • 3
  1. 1.Service de chirurgie viscéralecentre hospitalier de Saint-DenisSaint-Denis cedexFrance
  2. 2.Service de chirurgie viscéralecentre hospitalier de Saint-DenisSaint-DenisFrance
  3. 3.Service d’endocrinologiehôpital Avicenne, Assistance publique-Hôpitaux de ParisBobignyFrance

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