Advanced search
1 file | 276.45 KB Add to list

Life-threatening side effects of malabsorptive procedures in obese patients necessitating conversion surgery: a review of 17 cases

Wouter Willaert (UGent) , TOM HENCKENS (UGent) , Dirk Van de Putte (UGent) , Katrien Van Renterghem (UGent) , Wim Ceelen (UGent) , Piet Pattyn (UGent) and Yves Van Nieuwenhove (UGent)
(2012) ACTA CHIRURGICA BELGICA. 112(4). p.268-274
Author
Organization
Abstract
Background : malabsorptive surgery (MAS) can cause huge weight loss but is also known for its serious side effects: We investigated whether conversion surgery is an effective treatment for MAS-induced complications. Methods : we searched our hospital database for patients who underwent conversion surgery after MAS. Any complication was recorded till time of conversion. The conversion techniques and their effect on the course of the patients were analyzed and compared to the situation after MAS. Results : we identified 17 patients who suffered a wide range of complications after biliopancreatic diversion (BPD) (n = 11), biliopancreatic diversion with duodenal switch (BPD-DS) (n = 4), or distal gastric bypass (D-GBP) (n = 2). After a (mean +/- SD) period of 6.0 +/- 3.6 years the MAS was either converted to a gastric bypass (GBP) in 6 patients or an elongation of the common limb (ECL) in 9 patients. Two conversions were atypical. After a (mean +/- SD) follow-up of 2.4 +/- 2.5 years the majority of blood test results improved. The incidence of most complaints diminished except abdominal discomfort, critical illness polyneuropathy, need for total parenteral nutrition (TPN), wheelchair dependency, and asthenia. One patient died of irreversible liver failure after 3 liver transplantations. Two patients died of cachexia. The preferred conversion technique is still unclear. Conclusions : MAS can cause invalidating and life-threatening side effects. If there are signs of incipient deterioration in organ function and/or nutritional status, conversion surgery should not be delayed. Although we have the impression that early conversion causes better outcome, many patients experience lifelong postoperative complications.
Keywords
LIVER-TRANSPLANTATION, MORBID-OBESITY, HEPATOCELLULAR FAILURE, NUTRITIONAL DEFICIENCIES, GASTRIC BYPASS, DUODENAL SWITCH, BILIOPANCREATIC DIVERSION, BARIATRIC SURGERY, OPERATION, EXPERIENCE

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 276.45 KB

Citation

Please use this url to cite or link to this publication:

MLA
Willaert, Wouter, TOM HENCKENS, Dirk Van de Putte, et al. “Life-threatening Side Effects of Malabsorptive Procedures in Obese Patients Necessitating Conversion Surgery: a Review of 17 Cases.” ACTA CHIRURGICA BELGICA 112.4 (2012): 268–274. Print.
APA
Willaert, Wouter, HENCKENS, T., Van de Putte, D., Van Renterghem, K., Ceelen, W., Pattyn, P., & Van Nieuwenhove, Y. (2012). Life-threatening side effects of malabsorptive procedures in obese patients necessitating conversion surgery: a review of 17 cases. ACTA CHIRURGICA BELGICA, 112(4), 268–274.
Chicago author-date
Willaert, Wouter, TOM HENCKENS, Dirk Van de Putte, Katrien Van Renterghem, Wim Ceelen, Piet Pattyn, and Yves Van Nieuwenhove. 2012. “Life-threatening Side Effects of Malabsorptive Procedures in Obese Patients Necessitating Conversion Surgery: a Review of 17 Cases.” Acta Chirurgica Belgica 112 (4): 268–274.
Chicago author-date (all authors)
Willaert, Wouter, TOM HENCKENS, Dirk Van de Putte, Katrien Van Renterghem, Wim Ceelen, Piet Pattyn, and Yves Van Nieuwenhove. 2012. “Life-threatening Side Effects of Malabsorptive Procedures in Obese Patients Necessitating Conversion Surgery: a Review of 17 Cases.” Acta Chirurgica Belgica 112 (4): 268–274.
Vancouver
1.
Willaert W, HENCKENS T, Van de Putte D, Van Renterghem K, Ceelen W, Pattyn P, et al. Life-threatening side effects of malabsorptive procedures in obese patients necessitating conversion surgery: a review of 17 cases. ACTA CHIRURGICA BELGICA. 2012;112(4):268–74.
IEEE
[1]
W. Willaert et al., “Life-threatening side effects of malabsorptive procedures in obese patients necessitating conversion surgery: a review of 17 cases,” ACTA CHIRURGICA BELGICA, vol. 112, no. 4, pp. 268–274, 2012.
@article{5710705,
  abstract     = {Background : malabsorptive surgery (MAS) can cause huge weight loss but is also known for its serious side effects: We investigated whether conversion surgery is an effective treatment for MAS-induced complications. 
Methods : we searched our hospital database for patients who underwent conversion surgery after MAS. Any complication was recorded till time of conversion. The conversion techniques and their effect on the course of the patients were analyzed and compared to the situation after MAS. 
Results : we identified 17 patients who suffered a wide range of complications after biliopancreatic diversion (BPD) (n = 11), biliopancreatic diversion with duodenal switch (BPD-DS) (n = 4), or distal gastric bypass (D-GBP) (n = 2). After a (mean +/- SD) period of 6.0 +/- 3.6 years the MAS was either converted to a gastric bypass (GBP) in 6 patients or an elongation of the common limb (ECL) in 9 patients. Two conversions were atypical. After a (mean +/- SD) follow-up of 2.4 +/- 2.5 years the majority of blood test results improved. The incidence of most complaints diminished except abdominal discomfort, critical illness polyneuropathy, need for total parenteral nutrition (TPN), wheelchair dependency, and asthenia. One patient died of irreversible liver failure after 3 liver transplantations. Two patients died of cachexia. The preferred conversion technique is still unclear. 
Conclusions : MAS can cause invalidating and life-threatening side effects. If there are signs of incipient deterioration in organ function and/or nutritional status, conversion surgery should not be delayed. Although we have the impression that early conversion causes better outcome, many patients experience lifelong postoperative complications.},
  author       = {Willaert, Wouter and HENCKENS, TOM and Van de Putte, Dirk and Van Renterghem, Katrien and Ceelen, Wim and Pattyn, Piet and Van Nieuwenhove, Yves},
  issn         = {0001-5458},
  journal      = {ACTA CHIRURGICA BELGICA},
  keywords     = {LIVER-TRANSPLANTATION,MORBID-OBESITY,HEPATOCELLULAR FAILURE,NUTRITIONAL DEFICIENCIES,GASTRIC BYPASS,DUODENAL SWITCH,BILIOPANCREATIC DIVERSION,BARIATRIC SURGERY,OPERATION,EXPERIENCE},
  language     = {eng},
  number       = {4},
  pages        = {268--274},
  title        = {Life-threatening side effects of malabsorptive procedures in obese patients necessitating conversion surgery: a review of 17 cases},
  volume       = {112},
  year         = {2012},
}

Web of Science
Times cited: