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Bowel Reconstruction to Treat Chronic Diarrhea and Hypoproteinemia Following Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy: a Single-Site Experience

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Abstract

Background

Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) is a modification of the biliopancreatic diversion with duodenal switch (BPD-DS) surgery. A concern with SADI-S is chronic diarrhea and hypoproteinemia. Common channel lengthening (CCL) is a surgical procedure to increase absorption in the small intestine to decrease diarrhea.

Objectives

The aim of this study was to assess the occurrence and treatment of hypoproteinemia and chronic diarrhea with CCL following SADI-S surgery.

Setting

Private practice in the USA.

Methods

Patients were included if they underwent SADI-S from September 2013 to March 2018 and following surgery underwent CCL.

Results

Average operating time for laparoscopic CCL is 56.5 ± 4.6 min. The average bowel movements for the eight patients before laparoscopic CCL were 9.1 ± 4.7 a day. After the surgery, the bowel movements were reduced to 2.6 ± 0.4 a day. This difference was found to be statistically significantly different (p = .002). The two patients experiencing hypoproteinemia improved protein levels following CCL.

Conclusion

CCL is an effective way to treat symptomatic chronic diarrhea after SADI-S when conservative treatments have failed.

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Authors and Affiliations

  1. Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA

    Benjamin Horsley, Daniel Cottam, Austin Cottam, Samuel Cottam, Hinali Zaveri, Amit Surve & Walter Medlin

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  1. Benjamin Horsley
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  2. Daniel Cottam
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  3. Austin Cottam
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  4. Samuel Cottam
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  5. Hinali Zaveri
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  6. Amit Surve
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  7. Walter Medlin
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Corresponding author

Correspondence to Daniel Cottam.

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Conflict of Interest

Author 1 has no conflicts of interest to declare.

Author 2, the corresponding author, reports personal fees from Medtronic, outside the submitted work.

Author 3 has no conflicts of interest to declare.

Author 4 has no conflicts of interest to declare.

Author 5 has no conflicts of interest to declare.

Author 6 has no conflicts of interest to declare.

Author 7 has no conflicts of interest to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Horsley, B., Cottam, D., Cottam, A. et al. Bowel Reconstruction to Treat Chronic Diarrhea and Hypoproteinemia Following Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy: a Single-Site Experience. OBES SURG 29, 2387–2391 (2019). https://doi.org/10.1007/s11695-019-03847-y

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