Share This Article:

The Long Magenstrasse with pyloroplasty as functional gastric bypass: 6-years experience, 308 operations

Abstract Full-Text HTML Download Download as PDF (Size:641KB) PP. 935-940
DOI: 10.4236/health.2010.28138    4,384 Downloads   8,513 Views   Citations


Background: The Long Magenstrasse with py-loroplasty as functional Gastric Bypass (briefly LMGBP) procedure for morbid obesity may re- duce the incidence of side effects associated with gastric restrictive and malabsorptive sur- gery, particularly on quality of life and long-term nutritional insufficiency. In follow-up to pre- liminary findings in 34 patients, we report the results of an additional 274 LMGBPs performed over the past 3 years. Methods: Between October 2003 and 2009, 308 patients were treated with the LMGBP. 149 patients underwent open procedures; 74, hand-assisted laparoscopic surgery (HALS); and 85 were operated laparo-scopically. 17% had ≥ 125 mg/dl glycemia, 43% sleep apnea, 38% hyperlipidemia, 12% hyperuricemia, and 58% arterial hypertension under treatment. Results: The mean BMI of 256 pre-operatively normoglycemic patients at 1 year was 29 (range 26-31); 27 (25-30) in 45 patients at 3 years; and 27.5 (26-30) in 12 patients at 5 years. Mean BMI of 53 preoperatively hyperglycemic patients (≥ 125 mg/dl) at 1 year (21 patients) was 32 (29-34), and at 3 years (9 patients), 32.5 (30- 33). 15 patients with preoperative type 2 diabetes under oral treatment required no therapy 3-6 months after surgery. Patients reported considerable appetite reduction with rapid satiety but maintained good nutrition with no supplementation. There was no mortality. Conclusions: Safe and effective sustained weight loss, positive metabolic changes, and appetite diminution with rapid satiety were seen after LMGBP.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Vassallo, C. , Berbiglia, G. and Carena, M. (2010) The Long Magenstrasse with pyloroplasty as functional gastric bypass: 6-years experience, 308 operations. Health, 2, 935-940. doi: 10.4236/health.2010.28138.


[1] Baltazar, A., Bou, R., Cipagauta, L.A., et al. (1995) “Hy-brid” bariatric surgery: Biliopancreatic diversion and duodenal swich-preliminary experience. Obesity Surgery, 5(4), 419-423.
[2] Bastaroli, E., Della Valle, A., Vassallo, C., et al. (1993) Reflections on 4 years’ activity of an interdisciplinary center for the treatment of obese patients. Obesity Surgery, 3(3), 285-288.
[3] Marceau, P., Biron, S., Bourque, R.A., et al. (1992) Biliopancreatic diversion with a new type of gastrectomy. Obesity Surgery, 3(1), 29-35.
[4] Vassallo, C., Andreoli, M., La Manna, A., et al. (2001) 60 reoperations on 890 patients after gastric restrictive sur-gery. Obesity Surgery, 11(6), 752-756.
[5] Vassallo, C., Negri, L., Della Valle, A., et al. (1999) Di-vided vertical banded gastroplasty either for correction or as a first-choice operation. Obesity Surgery, 9(2), 177- 179.
[6] Vassallo, C., Negri, L, Berbiglia, G., et al. (2004) Bilio- pancreatic diversion with transitory gastric restriction and duodenal bulb preservation: 88 patients since 1992. Obesity Surgery, 14(6), 773-776.
[7] Johnston, D., Dachtler, J., Sue-Ling, H., et al. (2003) The Magenstrasse and Mill operation for morbid obesity. Obesity Surgery, 13(1), 10-16.
[8] Johnston, D. and Sue-Ling, H. (1995) Surgical treatment of morbid obesity. In: Cushieri, A., Moosa, A.R., Giles, G.R., Eds., Essential Surgical Practice. Butterworth- Heinemann, London, 1036-1044.
[9] Robinson, J., Sue-Ling, H. and Johnston, D. (2006) The Magenstrasse and Mill procedure can be combined with a Roux-en-Y gastric bypass to produce greater and sus-tained weight loss. Obesity Surgery, 16(7), 891-896.
[10] Vassallo, C., Berbiglia, G., et al. (2007) The Long Ma-genstrasse and Mill operation with pyloroplasty: Pre-liminary results. Obesity Surgery, 17(8), 1080-1083.
[11] Carmichael, A.R., Sue-Ling, H.M. and Johnston, D. (2001) Quality of life after the Magenstrasse and Mill procedure for morbid obesity. Obesity Surgery, 11(6), 708-715.
[12] Mason, E.E. (2005) The mechanisms of surgical treat- ment of type 2 diabetes. Obesity Surgery, 15(4), 459-461.
[13] Rubino, F., Forgione, A., Cummings, D.E., et al. (2006) The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intes-tine in the pathophysiology of type 2 diabetes. Annals of Surgery, 244(5), 741-749.
[14] Scopinaro, N., Papadia, F., et al. (2008) A comparison of a personal series of biliopancreatic diversion and litera-ture data and gastric bypass help to explain the mecha-nisms of resolution of type 2 diabetes by the two opera-tions. Obesity Surgery, 18(8), 1035-1038.
[15] Siewert, J.R. and Muller, C.. (1983) Terapia chirurgica dell’ulcera duodenale non complicata. In: Allg?wer, M., Harder, F., Hollender, L.F., Peiper, H.J. and Siewert, J.R., Eds. Trattato di Gastroenterologia Chirurgica. Antonio Delfino Editore, Rome, 2, 463-466.
[16] Amdrup, E. and Jensen, H.E. (1973) One hundred pa-tients five years after selective gastric vagotomy and drainage for duodenal ulcer. Surgery, 74, 321-325.
[17] Goligher, J.C., Pulvertaft, C.N., et al. (1972) Five to eight years results of truncal vagotomy and pyloroplasty for duodenal ulcer. British Medical Journal, 1(5791), 7-13.
[18] Johnston, D., Humphrey, C.S., et al. (1970) Should the gastric antrum be vagally denervated if it is well drained and in the acid stream? British Journal of Surgery, 58(10), 725-731.
[19] Thompson, J.D. and Galloway, J.B.W. (1979) Vagotomy and pyloric dilatation in chronic duodenal ulceration. British Medical Journal, 1(6176), 1453-1455.
[20] Taylor, T.V., Lythgoe, J.P., et al. (1990) Anterior lesser curve seromyotomy and posterior truncal vagotomy versus truncal vagotomy and pyloroplasty in the treatment of chronic duodenal ulcer. British Journal of Surgery, 77, 1007-1009.
[21] Almogy, G. Crookes, P.F., Anthone, G.I., et al. (2004) Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obesity Surgery, 14(4), 492-497.
[22] Morínigo, R., Lacy, A.M., et al. (2006) GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects. Obesity Surgery, 16(12), 1594-1601.
[23] Conce, M.E., Cottam, D. and Esplen, J. (2006) Is ghrelin the culprit for weight loss after gastric bypass surgery? A negative answer. Obesity Surgery, 16(7), 870-878.
[24] Frühbeck, G., Diaz-Caballero, A., Gil, M.J., et al. (2004) The decrease in plasma ghrelin concentrations following surgery depends on the functional integrity of the fundus. Obesity Surgery, 14(5), 606-612.
[25] Garcia-Fuentes, E., Garrido-Sanchez, L., et al. (2008) Different effect of laparoscopic Roux-en-Y gastric by-pass and open biliopancreatic diversion of Scopinaro on serum PYY and ghrelin levels. Obesity Surgery, 18, 1424-1429.
[26] Roth, C.L., Reinehr, T., et al. (2009) Ghrelin and obes-tatin levels in severely obese women before and after weight loss after Roux-en-Y gastric bypass surgery. Obesity Surgery, 19(1), 29-35.
[27] Reinehr, T., Roth, C.L., et al. (2007) Peptide YY and glucagon-like peptide-1 in morbidly obese patients be-fore and after surgically induced weight loss. Obesity Surgery, 17(12), 1571-1577.
[28] Reavis, K.M., Hinojosa, M.W., et al. (2008) Single lapar- oscopic incision transabdominal surgery sleeve gastrec-tomy. Obesity Surgery, 18(11), 1492-1494.
[29] Schweitzer, D.H. and Posthuma, E.F. (2008) Prevention of vitamin and mineral deficiencies after bariatric surgery: Evidence and algorithms. Obesity Surgery, 18(11), 1485- 1488.

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.