Reversible bilio-pancreatic diversion with explorable excluded stomach-the Messina technique

Obes Surg. 2014 Sep;24(9):1563-6. doi: 10.1007/s11695-014-1324-9.

Abstract

The authors propose a reversible bilio-pancreatic diversion with access to the bypassed stomach. In the Messina technique, bilio-pancreatic diversion is accomplished by transecting the stomach without gastric resection, as already described by Resa et al. In addition, a temporary gastrostomy is performed on the excluded stomach and allows direct postoperative exploration of the duodenum and the biliary tree. The Messina bilio-pancreatic diversion technique (MBPDT) seems to be safe and effective. The authors propose the MBPDT in a morbidly obese patient undergoing bariatric surgery when a malabsorptive operation is required, as it makes the original Scopinaro operation reversible, the bilio-pancreatic area explorable postoperatively, the operation shorter, and does not cause any significant increase in the postoperative complication rate. Larger numbers and longer follow-up, however, are needed to further confirm our data.

MeSH terms

  • Adult
  • Aged
  • Bariatric Surgery / methods
  • Biliopancreatic Diversion / methods*
  • Cohort Studies
  • Duodenum / surgery
  • Female
  • Gastric Bypass / methods*
  • Gastrostomy
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Stomach / surgery
  • Young Adult