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The first consensus statement on revisional bariatric surgery using a modified Delphi approach

机译：使用改进的Delphi方法撤销畜分手术的第一次共识陈述

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Background Revisional bariatric surgery (RBS) constitutes a possible solution for patients who experience an inadequate response following bariatric surgery or significant weight regain following an initial satisfactory response. This paper reports results from the first modified Delphi consensus-building exercise on RBS. Methods We created a committee of 22 recognised opinion-makers with a special interest in RBS. The committee invited 70 RBS experts from 27 countries to vote on 39 statements concerning RBS. An agreement amongst >= 70.0% experts was regarded as a consensus. Results Seventy experts from twenty-seven countries took part. There was a consensus that the decision for RBS should be individualised (100.0%) and multi-disciplinary (92.8%). Experts recommended a preoperative nutritional (95.7%) and psychological evaluation (85.7%), endoscopy (97.1%), and a contrast series (94.3%). Experts agreed that Roux-Y gastric bypass (RYGB) (94.3%), One anastomosis gastric bypass (OAGB) (82.8%), and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) (71.4%) were acceptable RBS options after gastric banding (84.3%). OAGB (84.3%), bilio-pancreatic diversion/duodenal switch (BPD/DS) (81.4%), and SADI-S (88.5%) were agreed as consensus RBS options after sleeve gastrectomy. lengthening of bilio-pancreatic limb was the only consensus RBS option after RYGB (94.3%) and OAGB (72.8%). Conclusion Experts achieved consensus on a number of aspects of RBS. Though expert opinion can only be regarded as low-quality evidence, the findings of this exercise should help improve the outcomes of RBS while we develop robust evidence to inform future practice.
机译：背景技术急性畜牧手术（RBS）构成了对患有父亲手术后经历不足或在初始令人满意的反应后重量恢复的患者的可能解决方案。本文报告了第一个改进的Delphi共识建设锻炼的结果。方法我们创建了一个22名知名签发者委员会，具有特别兴趣的叙述。委员会邀请了70个国家的70个RBS专家对39名关于RBS的陈述进行投票。 > = 70.0％的专家达成协议被视为共识。结果二十七个国家的七十个专家参加了部分。载人的决定应该是个性化（100.0％）和多学科（92.8％）。专家推荐术前营养（95.7％）和心理评估（85.7％），内窥镜检查（97.1％）和造影系列（94.3％）。专家们同意Roux-Y胃旁路（RYGB）（94.3％），一种吻合胃旁路（OAGB）（82.8％）和单吻合术患者（82.8％），具有套管胃切除术（SADI-S）（71.4％）是可接受的rbs胃带后的选择（84.3％）。 OAGB（84.3％），Bilio-Pancreatic转移/十二指肠开关（BPD / DS）（81.4％）和萨迪-S（88.5％）同意套管胃切除术后的共识RBS选项。 Bilio-Pancreatic Lemb的延长是RygB（94.3％）和OAGB（72.8％）后的唯一共有的RBS选项。结论专家对RBS的许多方面取得了共识。虽然专家意见只能被视为低质量的证据，但这项锻炼的结果应该有助于改善RB的结果，同时制定强大的证据，以告知未来的惯例。

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