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Intestinal bypass surgery can lead to loss of weight effectively, but it can also lead to various complications that should not be neglected. About half of the patients who received this surgery need rehospitalization to manage the complications. [5] The expected outcomes and possible risks of the intestinal bypass surgery are shown as follows:
Vitamin B 12 deficiency is quite common after gastric bypass surgery with reported rates of 30% in some clinical trials. [journal 13] Sublingual B 12 (cyanocobalamin) appears to be adequately absorbed. In cases where sublingual B 12 does not provide sufficient amounts, injections may be needed. Protein malnutrition is a real risk.
A single protocol is not superior to the other. In one 2019 systematic review, estimated weight loss (EWL) for each surgical protocol is as follows: 56.7% for gastric bypass, 45.9% for gastric banding, 74.1% for biliopancreatic bypass +/- duodenal switch and 58.3% for sleeve gastrectomy. [28]
In general surgery, a Roux-en-Y anastomosis, or Roux-en-Y, is an end-to-side surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. Typically, it is between stomach and small bowel that is distal (or further down the gastrointestinal tract) from the cut end. [1]
The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach (along the greater curvature) and most of the duodenum .
[8] [9] In many cases, sleeve gastrectomy is as effective as gastric bypass surgery, including improvements in glucose homeostasis before substantial weight loss has occurred. This weight-loss independent benefit is related to the decrease in gastric volume, changes in gut peptides, and expression of genes involved in glucose absorption. [10] [11]
Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine , bypassing the lower stomach, the duodenum , and the first portion of the jejunum .
[1] Over the years, the Billroth II operation has been colloquially referred to as any partial removal of the stomach with an end to side connection to the stomach as shown in the picture; however, technically, this picture is a modification of Billroth's operation called a partial gastrectomy with a Kronelein anastomosis where the divided end ...
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