Does anyone have experience with bariatric surgery while the patiënt is on PD. Our surgions performed a uncomplicated lap. Gastric sleeve. Now they want to do a gasrtic bypass in a patiënt with a history of a sleeve.

Questions About PD

M.a.m. Verhoeven, Doctor/MD from Netherlands asked
Does anyone have experience with bariatric surgery while the patiënt is on PD. Our surgions performed a uncomplicated lap. Gastric sleeve. Now they want to do a gasrtic bypass in a patiënt with a history of a sleeve.

1 answer

Susie Hu, MD from USA March 8, 2022

There are few publications of PD patients who undergo bariatric surgery. Reported cases were performed laparoscopically, without complications (leak, peritonitis, or surgical complications including adhesions) or interruption of peritoneal dialysis.  Reported cases included laparoscopic gastric banding, laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.  PD was held the night of surgery then resumed however with a modified dialysis prescription.  Dialysate volume was reduced and the day-dwell was held for a limited duration.  The full prescription was slowly reintroduced over a 3-4 week duration.  In some, this resulted in significant weight loss allowing for kidney transplantation listing. 
Nguyen AH, Naljayan M, Yazdi F, Reisin E. Laparoscopic Sleeve Gastrectomy in a Patient on Peritoneal Dialysis. Kidney Int Rep. 2020;5(12):2361-2364. Published 2020 Oct 3. doi:10.1016/j.ekir.2020.09.014
Valle G.A., Kissane B.E., de la Cruz-Munoz N. Successful laparoscopic bariatric surgery in peritoneal dialysis patients without interruption of their CKD6 treatment modality. Adv Perit Dial. 2012;28:134–139.
Imam TH, Wang J, Khayat FS. Bariatric surgery in a patient on peritoneal dialysis. Perit Dial Int. 2013;33(6):710-711. doi:10.3747/pdi.2012.00272
 

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