PMID- 31218425
OWN - NLM
STAT- MEDLINE
DCOM- 20210524
LR  - 20221024
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 34
IP  - 4
DP  - 2020 Apr
TI  - The first consensus statement on revisional bariatric surgery using a modified 
      Delphi approach.
PG  - 1648-1657
LID - 10.1007/s00464-019-06937-1 [doi]
AB  - BACKGROUND: Revisional bariatric surgery (RBS) constitutes a possible solution 
      for patients who experience an inadequate response following bariatric surgery or 
      significant weight regain following an initial satisfactory response. This paper 
      reports results from the first modified Delphi consensus-building exercise on 
      RBS. METHODS: We created a committee of 22 recognised opinion-makers with a 
      special interest in RBS. The committee invited 70 RBS experts from 27 countries 
      to vote on 39 statements concerning RBS. An agreement amongst >/= 70.0% experts was 
      regarded as a consensus. RESULTS: Seventy experts from twenty-seven countries 
      took part. There was a consensus that the decision for RBS should be 
      individualised (100.0%) and multi-disciplinary (92.8%). Experts recommended a 
      preoperative nutritional (95.7%) and psychological evaluation (85.7%), endoscopy 
      (97.1%), and a contrast series (94.3%). Experts agreed that Roux-Y gastric bypass 
      (RYGB) (94.3%), One anastomosis gastric bypass (OAGB) (82.8%), and single 
      anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) (71.4%) were 
      acceptable RBS options after gastric banding (84.3%). OAGB (84.3%), 
      bilio-pancreatic diversion/duodenal switch (BPD/DS) (81.4%), and SADI-S (88.5%) 
      were agreed as consensus RBS options after sleeve gastrectomy. lengthening of 
      bilio-pancreatic limb was the only consensus RBS option after RYGB (94.3%) and 
      OAGB (72.8%). CONCLUSION: Experts achieved consensus on a number of aspects of 
      RBS. Though expert opinion can only be regarded as low-quality evidence, the 
      findings of this exercise should help improve the outcomes of RBS while we 
      develop robust evidence to inform future practice.
FAU - Mahawar, Kamal K
AU  - Mahawar KK
AUID- ORCID: 0000-0003-2551-3462
AD  - Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. 
      kmahawar@gmail.com.
FAU - Himpens, Jacques M
AU  - Himpens JM
AD  - St Pierre University Hospital, Brussels, Belgium.
FAU - Shikora, Scott A
AU  - Shikora SA
AD  - Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
FAU - Ramos, Almino C
AU  - Ramos AC
AD  - Gastro-Obeso-Center Metabolic Optimisation Institute, Sao Paulo, Brazil.
FAU - Torres, Antonio
AU  - Torres A
AD  - Hospital Clinico San Carlos, Complutense University, Madrid, Spain.
FAU - Somers, Shaw
AU  - Somers S
AD  - Portsmouth Hospitals NHS Trust, Portsmouth, UK.
FAU - Dillemans, Bruno
AU  - Dillemans B
AD  - AZ Sint Jan AV, Bruges, Oostend, Belgium.
FAU - Angrisani, Luigi
AU  - Angrisani L
AD  - Department of Public Health, University of Naples "Federico II", Naples, Italy.
FAU - Greve, Jan Willem M
AU  - Greve JWM
AD  - Zuyderland Medical Center, Heerlen, The Netherlands.
AD  - The Netherlands and Maastricht University (MUMC+), Maastricht, The Netherlands.
FAU - Chevallier, Jean-Marc
AU  - Chevallier JM
AD  - Universite Paris 5, Paris, France.
FAU - Chowbey, Pradeep
AU  - Chowbey P
AD  - Max Institute of Minimal Access Metabolic and Bariatric Surgery, Max Hospital, 
      Saket, New Delhi, India.
FAU - De Luca, Maurizio
AU  - De Luca M
AD  - Castelfranco and Montebelluna Hospitals, Treviso, Italy.
FAU - Weiner, Rudolf
AU  - Weiner R
AD  - Clinic Obesity Surgery, Sana-Klinikum Offenbach, Offenbach, Germany.
FAU - Prager, Gerhard
AU  - Prager G
AD  - Medical University of Vienna, Vienna, Austria.
FAU - Vilallonga, Ramon
AU  - Vilallonga R
AD  - Universitary Hospital Vall Hebron, Barcelona, Spain.
FAU - Adamo, Marco
AU  - Adamo M
AD  - University College London Hospital, London, UK.
FAU - Sakran, Nasser
AU  - Sakran N
AD  - Emek Medical Center, Afula, Israel.
FAU - Kow, Lilian
AU  - Kow L
AD  - Flinders Private Hospital, Adelaide, Australia.
FAU - Lakdawala, Mufazzal
AU  - Lakdawala M
AD  - Digestive Health Institute, Saifee Hospital, Mumbai, India.
FAU - Dargent, Jerome
AU  - Dargent J
AD  - Polyclinique Lyon Nord, Lyon, France.
FAU - Nimeri, Abdelrahman
AU  - Nimeri A
AD  - Bariatric & Metabolic Institute (BMI), Abu Dhabi, United Arab Emirates.
FAU - Small, Peter K
AU  - Small PK
AD  - Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
LA  - eng
PT  - Consensus Development Conference
PT  - Journal Article
DEP - 20190619
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Adult
MH  - Bariatric Surgery/*methods
MH  - Biliopancreatic Diversion/methods
MH  - *Consensus
MH  - *Delphi Technique
MH  - Duodenum/surgery
MH  - Female
MH  - Gastrectomy/methods
MH  - Gastric Bypass/methods
MH  - Humans
MH  - Middle Aged
MH  - Obesity, Morbid/surgery
MH  - Preoperative Care
MH  - Reoperation
OTO - NOTNLM
OT  - Band to bypass
OT  - Band to sleeve
OT  - Bariatric surgery
OT  - Conversion
OT  - Gastric banding
OT  - Obesity surgery
OT  - One anastomosis gastric bypass
OT  - Revisional bariatric surgery
OT  - Roux-en-Y gastric bypass
OT  - Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy
OT  - Sleeve gastrectomy
OT  - Sleeve to bypass
OT  - Weight regain
EDAT- 2019/06/21 06:00
MHDA- 2021/05/25 06:00
CRDT- 2019/06/21 06:00
PHST- 2019/01/23 00:00 [received]
PHST- 2019/06/12 00:00 [accepted]
PHST- 2019/06/21 06:00 [pubmed]
PHST- 2021/05/25 06:00 [medline]
PHST- 2019/06/21 06:00 [entrez]
AID - 10.1007/s00464-019-06937-1 [pii]
AID - 10.1007/s00464-019-06937-1 [doi]
PST - ppublish
SO  - Surg Endosc. 2020 Apr;34(4):1648-1657. doi: 10.1007/s00464-019-06937-1. Epub 2019 
      Jun 19.