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Duodenal Switch Revision Surgery

Revision after failed bariatric surgery

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Duodenal Switch Revision Surgery?

Duodenal switch revision is the conversion of a previous bariatric procedure to duodenal switch (or its modification, SADI-S) in patients with insufficient weight loss or weight regain.

After sleeve gastrectomy with inadequate weight loss, duodenal switch can be planned as a second stage that adds a malabsorptive component via small bowel bypass.

After gastric bypass, revision addresses pouch dilation or gastrojejunostomy enlargement; conversion to duodenal switch carries a higher mortality and complication risk than primary surgery.

Symptoms

Insufficient weight loss after sleeve gastrectomy
Weight regain after bariatric surgery
BMI >50 (super-obese)
Dumping syndrome
Hypoglycaemia episodes (post-bariatric)
Pouch dilation after gastric bypass
Gastrogastric fistula
Resistant comorbid metabolic disease

Risk Factors

Malnutrition and vitamin deficiencies
Protein deficiency (hypoalbuminaemia)
Ileus and bowel obstruction
Anastomotic leak after revision
Mortality (1-3%, higher than primary surgery)
Need for long-term follow-up
Severe diarrhoea and malabsorption
Liver failure (rare but serious)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Vomiting and inability to take oral intake
  • Abdominal pain (anastomotic leak)
  • Fever and systemic infection
  • Jaundice (biliary obstruction)
  • Rapid weight loss and weakness

Treatment Methods

01
Preoperative multidisciplinary evaluation
02
Laparoscopic takedown of prior anastomoses and adhesions
03
Assessment of remaining gastric volume
04
Re-sleeve or full sleeve creation if required
05
Sequential measurement of duodenum to biliopancreatic limb
06
Duodenoileostomy anastomosis (150-250 cm common channel)
07
Distal jejunoileostomy with 100 cm alimentary loop
08
Long-term vitamin and protein support with follow-up

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.