{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:27:41Z","timestamp":1791044861501,"version":"4.1.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Metabolic and nutritional complications\u2014including intractable dumping syndrome (DS), gastroesophageal reflux disease (GERD), anemia, and weight recurrence\u2014may develop long after Roux-en-Y gastric bypass (RYGB). Current revisional options, such as reversal or distalization, can be technically demanding and may worsen malabsorption. Restoring gastric continuity and pyloric function may offer physiological benefits. This study evaluated the feasibility and early outcomes of small bowel length optimization and shortening with sleeve gastrectomy (BOS-SG) as a revisional strategy after RYGB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Procedures:<\/jats:title>\n                    <jats:p>This retrospective analysis included 8 consecutive female patients who underwent BOS-SG, with or without hiatal hernia repair, between 2018 and 2023 at a tertiary center. Indications were refractory DS, GERD, anemia unresponsive to medical therapy, and weight recurrence. A standardized multidisciplinary and endoscopic evaluation was performed preoperatively. Perioperative parameters and postoperative clinical outcomes were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All procedures were completed laparoscopically without conversion. The mean operative time was 168 minutes, and the mean hospital stay was 5 days. Compared with pre-revision status, patients achieved a mean weight loss of 6.7 kg, corresponding to 7.9% total weight loss and 39.9% excess weight loss. DS resolved in all patients. GERD improved in 60% of symptomatic patients, and 60% of those with anemia normalized hemoglobin. Two patients (25%) required reoperation, 1 for recurrent hiatal hernia, and 1 for an anastomotic leak, both managed laparoscopically with good recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>BOS-SG appears feasible and may provide physiological advantages through restoration of gastric continuity and pyloric function in selected patients with post-RYGB metabolic or nutritional complications. Larger prospective studies are needed to validate these early findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261442508","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T07:23:38Z","timestamp":1775633018000},"page":"751-757","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of Small Bowel Length Shortening with Sleeve Gastrectomy for Metabolic and Nutritional Complications After RYGB"],"prefix":"10.1177","volume":"36","author":[{"given":"Chih-Kun","family":"Huang","sequence":"first","affiliation":[{"name":"College of Medicine, China Medical University, Taichung, Taiwan."},{"name":"Department of Surgery, Division of Metabolic &amp; Bariatric Surgery, China Medical University Hospital, Taichung, Taiwan."},{"name":"Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herson","family":"Sadian Jr","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Metabolic &amp; Bariatric Surgery, China Medical University Hospital, Taichung, Taiwan."},{"name":"Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Che","family":"Hsin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Metabolic &amp; Bariatric Surgery, China Medical University Hospital, Taichung, Taiwan."},{"name":"Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long-Bin","family":"Jeng","sequence":"additional","affiliation":[{"name":"College of Medicine, China Medical University, Taichung, Taiwan."},{"name":"Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan."},{"name":"Department of Surgery, China Medical University Hospital, Taichung, Taiwan."},{"name":"Cell Therapy Center, China Medical University Hospital, Taichung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Chih","family":"Chang","sequence":"additional","affiliation":[{"name":"Weight Management Center, Kaohsiung Medical University Hospital\/Kaohsiung Medical University, Kaohsiung City, Taiwan."},{"name":"Department of Surgery, Division of Thoracic Surgery, Kaohsiung Medical University Hospital\/Kaohsiung Medical University, Kaohsiung City, Taiwan."},{"name":"School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan."},{"name":"Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan."},{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2188-1797","authenticated-orcid":false,"given":"Ting-Wei","family":"Chang","sequence":"additional","affiliation":[{"name":"Weight Management Center, Kaohsiung Medical University Hospital\/Kaohsiung Medical University, Kaohsiung City, Taiwan."},{"name":"Department of Surgery, Division of Thoracic Surgery, Kaohsiung Medical University Hospital\/Kaohsiung Medical University, Kaohsiung City, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0115426505020005517"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.02.002"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089206777822179"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-010-0252-6"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089205774859173"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9609-x"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1381\/096089201321577866"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2007.07.010"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1133415"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2012.12.004"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3848-4"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.3654"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-019-04018-9"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.JMAS_12_20"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182683037"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2016.03.004"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2012.02.006"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-010-0247-3"},{"issue":"11","key":"e_1_3_2_20_1","first-page":"e48864","article-title":"Minimally invasive gastrointestinal surgery: A review","volume":"15","author":"Singh SS","year":"2023","unstructured":"19.Singh SS, , Shinde RK. 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