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Laparoscopic Sleeve Gastrectomy with Duodeno-Jejunal Bypass: A New Surgical Procedure for Weight Control. Feasibility and Safety Study in a Porcine Model

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Abstract

Background

One limit of the Roux-en-Y gastric bypass (GBP) is the preclusion of exploring the bypassed stomach with conventional endoscopy and radiological studies. In this study, we explored the feasibility, safety, and weight progression of a new bariatric procedure that eliminates this inconvenience.

Methods

Eleven 40- to 50-kg Yorkshire pigs underwent laparoscopic sleeve gastrectomy and Roux-en-Y duodeno-jejunal bypass (SG-DJBP). Weight was monitored at postoperative days 15 and 30 and after 3 months; weight progression was compared with an identical group that underwent a sham procedure or GBP. At autopsy, surgical site was evaluated at microscopic and macroscopic level.

Results

Mean operating time was 66 ± 5.76 min. All the survivors tolerated the procedure well, except one subject that experienced a gastric leak from the stapler line. The SG-DJBP had a had significantly slower weight gains than the sham group (P = 0.005). The absence of histological abnormalities in the duodenal wall was confirmed at autopsy.

Conclusion

SG-DJBP is feasible and produces effects of weight progression comparable to those of GBP. Being a combination of previously standardized procedures, we are confident to propose this procedure as a bariatric alternative in humans. Long-term follow-up will be required to establish the efficacy on weight loss in humans.

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Abbreviations

SG-DJBP:

laparoscopic sleeve gastrectomy and Roux-en-Y duodeno-jejunal bypass

SG:

sleeve gastrectomy

GBP:

Roux-en-Y gastric bypass

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Acknowledgments

This study was completed in the Minimally Invasive Surgery Center of Mount Sinai School of Medicine (NY), funded in part by unrestricted grants from Tyco Healthcare and Karl Storz Endoscopy of America. Dr. del Genio’s research fellowship was funded in part by the Department of Surgery of the Seconda Università degli Studi di Napoli, Italy.

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Authors and Affiliations

  1. Foregut and Obesity Pathophysiology Study Center, Department of Surgery, University of Naples II, via Pansini 5, Naples, 80131, Italy

    Gianmattia del Genio, Federica del Genio & Alberto del Genio

  2. Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL, 33140, USA

    Michel Gagner

  3. Department of Surgery, Mount Sinai Hospital, 5 East, 98th Street, Box 1103, New York, NY, 10029, USA

    Federico Cuenca-Abente, David Nocca, Laurent Biertho & Ahmad Assalia

  4. Department of Surgery, University of Naples II, Via Strettola a Chiaia, 7, 80122, Naples, Italy

    Gianmattia del Genio

Authors
  1. Gianmattia del Genio
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  2. Michel Gagner
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  3. Federico Cuenca-Abente
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  4. David Nocca
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  5. Laurent Biertho
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  6. Federica del Genio
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  7. Ahmad Assalia
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  8. Alberto del Genio
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Corresponding author

Correspondence to Gianmattia del Genio.

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Funding/Grant support: None

Conflicts of interest: None

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del Genio, G., Gagner, M., Cuenca-Abente, F. et al. Laparoscopic Sleeve Gastrectomy with Duodeno-Jejunal Bypass: A New Surgical Procedure for Weight Control. Feasibility and Safety Study in a Porcine Model. OBES SURG 18, 1263–1267 (2008). https://doi.org/10.1007/s11695-008-9602-z

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  • DOI: https://doi.org/10.1007/s11695-008-9602-z

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