ACTUALIDAD. ACTUALIDAD

POSTED 12 de agosto de 2019

IFSO 2019 Madrid

International Federation for the Surgery of Obesity and Metabolic Disorders

OAGB/MGB – Indications and controversies

Chair:
Miguel A. Carbajo (Spain-EC)
Co-chairs:
Jean Marc Chevallier (France-EC)
Kuldeepak S. Kular (India-APC)
Mario Antozzi (Argentina-LAC)
Cesare Peraglie (USA-NAC)
Osama Taha (Egypt- MENAC)

08:55 - 09:00 Welcome Opening and Overview – Miguel A. Carbajo (Spain-EC)

09:00 – 11:00 Module 1 – Technical Aspects of OEAGB and MGB / Weight loss, Comorbidity resolution and quality of life
Moderator: Jean Marc Chevallier (France-EC) and Mario Antonzzi (Argentina-LAC)

• 09:00-09:15 Key steps to correctly perform an OAGB. Miguel A. Carbajo (Spain-EC)
• 09:15-09:30 Key steps to correctly perform a MGB. Kuldeepak S. Kular (India-APC)
• 09:30-09:45 Long-term outcomes after OAGB. Enrique Luque de León (Mexico-LAC)
• 09:45-10:00 Long-term outcomes after MGB. Mario Musella (Italy-EC)
• 10:00-10:15 Long-term Diabetes remission after OAGB/MBG. Osama Taha (Egypt-MENAC)
• 10:15-10:30 Long-term results after OAGB at the Extremes of Life Jaime Ruiz-Tovar (Spain-EC)
• 10:30-10:45 Long-term results after OAGB/MBG in Super-Super obese Patients Cesare Peraglie (USA-NAC)
• 10:45-11:00 Open Debate – Q&A

11:00 – 11:30 Coffee Break

11:30 - 13:30 Module 2 – Metabolic effects of OAGB/MGB / Comparative results with other techniques / Roles of OAGB/MBG as revisional surgery
Moderators: Gerhard Prager (Austria-EC) and Jorge Santos (Portugal-EC)

• 11:30-11:45 Metabolic effects after OAGB/MBG. Jean-Marc Chevallier (France-EC)
• 11:45-12:00 Type II Diabetes before and after OAGB/MBG. Lorea Zubiaga (France-EC)
• 12:00-12:15 Metabolic Syndrome: Long-Term Results after OAGB/MBG Salvador Navarrete (Venezuela-LAC)
• 12:15-12:30 Comparative Studies between OAGB/MBG and Sleeve Gastrectomy Luciano Antozzi (Argentina-LAC)
• 12:30-12:45 Comparative Studies between OAGB/MBG and Roux-Y-Gastric Bypass Rudolf Weiner (Germany-EC)
• 12:45-13:00 “OAGB vs RYGB as Revisional Surgery after failed restrictive procedures” Osama Taha (Egypt-MENAC)
• 13:00-13:15 Current and Future role of OAGB/MBG as Revisional Surgery after other Failed procedures. Luciano Antozzi (Argentina-LAC)
• 13:15-13:30 Open Debate – Q&A


13:30 - 14:30 Lunch

14:30 - 16:30 Module 3 – Controversies in OAGB/MGB / Perioperative and Long-term complications / Limb lengths
Moderators: Nasser Sakran (Israel-EC) and Enrique Luque de León (México-LAC)

• 14:30-14:45 Biliary reflux – Myths and realities Mario Mussela (Italy-EC)
• 14:45-15:00 Esophageal Cancer – Myths and realities Karl Rheinwalt (Germany-EC)
• 15:00-15:15 Leaks, Bleeding, Internal hernias and other perioperative complications after OAGB/MBG Ramiro Carbajal (Perú-LAC)
• 15:15-15:30 Prevention and management of nutritional deficiencies Enrique Luque de León (México-LAC)
• 15:30-15:45 Revision of OAGB/MGB – Indications, Alternatives and Outcomes Arun Prasad (India-APC)
• 15:45-16:00 Limb Lengths in MGB – Current Concepts and Controversies Mohit Bhandari (India-APC)
• 16:00-16:15 “Ideal” Limb Lenghts – Progressive Principles after a Long-Term Experience with OAGB Jaime Ruiz-Tovar (Spain-EC)
• 16:15-16:30 Open Debate – Q&A


16:30 - 17:30 Module 4 – Testing learning process interactive session
Moderators: Ramón Vilallonga (Spain-EC), Enrique Luque de León (México-LAC)

Clinical Case Discussions:
Case Report No. 1
“OAGB/MGB in the setting of a large hiatal hernia and Barret´s esophagus”
Description: 54 year-old male with BMI=42, type II DM, HTN and GERD with a hiatal hernia > 4 cm and Barrett’s esophagus. Is this a contraindication for OAGB/MGB? How should this case be approached?
Luciano Antozzi (Argentina-LAC)

Case Report No. 2
“Malnutrition after conversion of MGB to RYGB for bile reflux – The importance of whole small bowel measuring”
Description: Patient with bile reflux after OAGB/MGB with a presumed 2 m. biliopancreatic limb (BPL) led to conversion to RYGB. Malnutrition was later developed and upon reoperation a BPL of 2.7 out of a total small bowel length of 4 m. was found!!
Jean Marc Chevallier (France-EC)

Case Report No. 3
“Revision for weight regain in a patient with previous MGB and gastro gastric fistula”
Description: video case presentation with discussion Cesare Peraglie (USA-NAC)

Case Report No. 4 – Video
“Fixed vs tailored limb lengths in OAGB/MGB”
Description: 44 year-old superobese female (BMI=63) with metabolic syndrome including type II DM and HTN is submitted to OAGB. How should degree of malabsortion be determined? Fixed 150, 200 or 250 cm bilio-pancreatic limb?...or should total small bowel length be included as a variable in the equation?
Miguel A. Carbajo (Spain-EC)

Case Report No. 5 – Video
“Management of malnutrition after OAGB associated with Whipple disease – A novel method for lengthening the common limb”
Description: 47 year-old male with BMI=48, central obesity and severe metabolic syndrome. OAGB was performed (BPL=320 cm, common limb=170 cm). At follow-up one year after he was asymptomatic, with BMI=26.6 and nutritionally intact. Later, a severe pneumonic process was followed by intense diarrhea and malnutrition. Which diagnostic algorithm should be followed? Differential diagnosis? How should this patient be managed: Conservative (medical) measures and/or surgical treatment?
Lorea Zubiaga (France-EC)

Case Report No. 6 – Video
“Prevention and Laparoscopic Management of Perforated Marginal Ulcer”
Description: 31 year-old female. An uneventful OAGB was performed. Nine months after she developed suddenly severe abdominal pain after intake of Aines and analgesics drugs. Endoscopy and emergency laparoscopy was performed successfully. What kind of ulcers appear in the OAGB/MBG? What role can play the use of pre, intra and postoperative endoscopy? How long do they have to take PPI treatment? What kind of prevention measures should be taken?
Luciano Antozzi (Argentina-LAC)

Case Report No. 7
“A severe complication of MGB: Twisted MGB with Bleeding and Leakage”
Description: We present a case of total twisted MGB procedure accompanied by bleeding and leakage. Urgent surgical solution was required. What causes it? Type of anastomosis? No intestinal fixation? What is its frequency and what mechanisms should be used to prevent this serious complication? In case of anastomotic leak, what attitude should be followed? In case of intestinal leak, which is advised to perform?
Jean Marc Chevallier (France-EC)

17:30 Final Remarks and conclusions Miguel A. Carbajo (Spain-EC)

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