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Inicio Cirugía Española Use of the Branco-Zorron Switch in a case of hyperinsulinemic hypoglicemia after...
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Vol. 100. Núm. 10.
Páginas 647-648 (Octubre 2022)
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Vol. 100. Núm. 10.
Páginas 647-648 (Octubre 2022)
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Use of the Branco-Zorron Switch in a case of hyperinsulinemic hypoglicemia after Roux en Y gastric bypass
El Switch de Branco-Zorron como opción técnica para el tratamiento de la hipoglucemia hiperinsulinémica después de Bypass gástrico en Y de Roux
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Javier Osorio1, Lucia Sobrino, Elisabet Baena, Claudio Lazzara1,
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clazzara@bellvitgehospital.cat

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Department of General and Digestive Surgery, Bariatric and Metabolic Surgery Unit, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain
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Post-bariatric surgery hypoglycemia is a rare and challenging complication. Restoration of the normal anatomy with gastro-gastric anastomosis has been tried with risk of weight regain. We present jejunal interposition permitting nutrient flow through pylorus and duodenum (‘Branco-Zorron Switch’) restoring the normal gastrointestinal hormonal mechanisms, while maintaining weight control. Surgery started with identification of the gastro-jejunostomy and all limbs measuring: alimentary limb: 90cm; biliopancreatic limb: 90cm and common limb: 275cm. Excluded stomach was resected, preserving 3cm of distal antrum; then, resection of the alimentary limb from 20cm of the gastro-jejunostomy down to the Y-jejuno-jejunal anastomosis and finally an handsewn end-to-end jejunal-antral anastomosis was performed (Fig. 1, Video) This jejuno-antral anastomosis is a much simpler procedure with less potential postoperative complications than gasto-gastric anastomosis.

Fig. 1
(0,12MB).

After 9 months follow-up, patient had no further hypoglycemic episodes and did not experienced food intolerance, nor any other complications.

Funding

There were no grants provided for this study.

Appendix A
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(81,85MB)

Javier Osorio and Claudio Lazzara contributed equally to this study.

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