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C J Lee, T T Brown, L J Cheskin, P Choi, T H Moran, L Peterson, R Matuk, K E Steele
BACKGROUND: Meal tolerance tests are frequently used to study dynamic incretin and insulin responses in the postprandial state; however, the optimal meal that is best tolerated and suited for hormonal response following surgical and medical weight loss has yet to be determined. OBJECTIVE: To evaluate the tolerability and effectiveness of different test meals in inducing detectable changes in markers of glucose metabolism in individuals who have undergone a weight loss intervention...
December 2015: Obesity Science & Practice
Allison R Schulman, Walter Chan, Aiofe Devery, Michele B Ryan, Christopher C Thompson
BACKGROUND AND AIMS: Marginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) are frequently prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules, OCs) might be more easily absorbed than intact capsules (IC)...
October 20, 2016: Clinical Gastroenterology and Hepatology
Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Reena Sudan, Ranjan Sudan, Elizabeth Lyden, Jon S Thompson
BACKGROUND: Food cravings and consumption of craved foods after Roux-en-Y gastric bypass (RYGB) are poorly understood. Food cravings after bariatric surgery may explain why some patients fail to change eating behaviors after RYGB, and understanding these cravings may provide better information for nutritional counseling to either enhance weight loss or prevent weight regain. OBJECTIVES: To study cravings in RYGB patients and compare them with cholecystectomy (CC) control patients...
September 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Michael G White, Marc A Ward, Megan K Applewhite, Harry Wong, Vivek Prachand, Peter Angelos, Edwin L Kaplan, Raymon H Grogan
BACKGROUND: With over 110,000 bariatric operations performed in the United States annually, it is important to understand the biochemical abnormalities causing endocrine dysfunction associated with these procedures. Here we compare 2 malabsorptive procedures, duodenal switch and Roux-en-Y gastric bypass, to determine the role malabsorption plays in secondary hyperparathyroidism in this population. METHODS: Data from all super-obese patients undergoing duodenal switch or Roux-en-Y gastric bypass between August 2002 and October 2005 were prospectively collected...
October 18, 2016: Surgery
Ana Karen Medina Lira, Argenis Jose Mayorga Soto, Pamela Frigerio
BACKGROUND: Choledochal cyst is a congenital dilatation of the biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Vater first described choledochal cyst in 1723. Open excision was the standard procedure made a great impact in the treatment but since 1995 Farello et al. first reported laparoscopic choledochal cyst excision and this has been used worldwide. CASE REPORT: Female, 17 years old, past medical history two years ago a laparoscopic cholecystectomy for gallbladders...
October 5, 2016: International Journal of Surgery Case Reports
Peter Mathijs van Brussel, Bas van den Bogaard, Barbara A de Weijer, Jasper Truijen, Paul Ct Krediet, Ignace M Janssen, Arnold van de Laar, Karin A Kaasjager, Eric Fliers, Johannes J Van Lieshout, Mireille Johanna Serlie, Bert-Jan H van den Born
BACKGROUND: Blood pressure (BP) decreases in the first weeks after Roux-and-Y gastric bypass surgery. Yet, the pathophysiology of the BP lowering effects observed after gastric bypass surgery are incompletely understood. METHODS: We evaluated BP, systemic hemodynamics and baroreflex sensitivity in 15 obese women (mean age 42±7 yrs, body mass index 45±6 kg/m(2)) two weeks before and six weeks following Roux-and-Y gastric bypass surgery. RESULTS: Six weeks after gastric bypass surgery mean body weight decreased by 13±5 kg (10%, p<0...
October 20, 2016: Journal of Applied Physiology
John Melissas, Konstantinos Stavroulakis, Vassilis Tzikoulis, Angeliki Peristeri, John A Papadakis, Abdolreza Pazouki, Alireza Khalaj, Ali Kabir
BACKGROUND: The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program. METHODS: Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared. RESULTS: There were steadily increasing numbers of patients underwent SG from 2010 to 2015...
October 20, 2016: Obesity Surgery
Muhammad A Jawad, Lars Nelson, Rena C Moon, Andre F Teixeira
BACKGROUND: Although effective, duodenal switch can be a complicated and time-consuming operation for surgeons. PURPOSE: The purpose of this article is to present our technique of biliopancreatic diversion and vertical sleeve gastrectomy, creating a 150-cm common channel and a 100-cm alimentary limb. MATERIAL AND METHODS: A robot-assisted technique was utilized in creating a biliopancreatic diversion and vertical sleeve gastrectomy. RESULTS: Laparoscopy was used for marking stitches and then the robot was docked...
October 19, 2016: Obesity Surgery
Masanori Yamada, Koji Nakai, Kentaro Inoue, Takeshi Hijikawa, Hiroaki Kitade, Kazuhiko Yoshioka, Masanori Kon
An 81-year-old man underwent total gastrectomy with Roux-en-Y reconstruction for cardiac cancer in our department. He developed high fever on postoperative day 3, and pathological examination showed WBC and CRP level of 12,000/mL and 29.983mg/dL, respectively. A diagnosis of anastomotic leakage was confirmed using enhanced abdominal CT scanning that demonstrated free air around the esophagojejunalanastomosis after totalgastrectomy. The drainage tube was replaced by a 12 Fr sump tube because of leakage on postoperative day 10...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Gisele Farias, Rubia D Thieme, Laila M Teixeira, Maria Emilia V D Heyde, Solange C Bettini, Rosana B Radominski
BACKGROUND: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. OBJECTIVES: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. METHODS: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jaime Ruiz-Tovar, Pablo Royo, José L Muñoz, Manuel Duran, Elisabeth Redondo, Jose M Ramirez
INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery...
October 7, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Lava Y Patel, Brittany Lapin, Craig S Brown, Thomas Stringer, Matthew E Gitelis, John G Linn, Woody E Denham, Elizabeth Farwell, Stephen Haggerty, Michael B Ujiki
BACKGROUND: Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques...
October 17, 2016: Surgical Endoscopy
(no author information available yet)
PURPOSE: The Korean Gastric Cancer Association (KGCA) has conducted nationwide surveys every 5 years, targeting patients who received surgical treatment for gastric cancer. We report the results of the 2014 nationwide survey and compare them to those of the 1995, 1999, 2004, and 2009 surveys. MATERIALS AND METHODS: From March 2015 to January 2016, a standardized case report form was sent to every member of the KGCA via e-mail. The survey consisted of 29 questions, regarding patient demographics as well as tumor-, and surgery-related factors...
September 2016: Journal of Gastric Cancer
Yuqin Huang, Sen Wang, Dong Tang, Youquan Shi, Wei Wang, Yang Chong, Huaicheng Zhou, Qingquan Xiong, Jie Wang, Daorong Wang
Uncut Roux-en-Y gastrojejunostomy is a modification of the Billroth II procedure with Braun anastomosis, in which a jejunal occlusion is fashioned to avoid the Roux Stasis Syndrome. This review aimed to summarize the current knowledge about the uncut Roux-en-Y anastomosis operation, so that surgeons may be able to make informed decisions about its clinical application. Additionally, we hope that our findings will guide future research on this topic. Areas covered: The original uncut technique was associated with dehiscence or recanalization of the jejunal occlusion, and was therefore not widely applied...
October 17, 2016: Expert Review of Gastroenterology & Hepatology
Ryan E R Reid, Ekaterina Oparina, Hugues Plourde, Ross E Andersen
We explored differences in dietary behaviours, energy, and macronutrient intake among individuals who had regained or maintained weight loss 5 or more years after Roux-en-Y gastric bypass (RYGB). This study assessed 27 adults who underwent RYGB an average of 12.1 ± 3.7 years before this study was conducted. Dietary assessment was performed using 3-day food records. Daily energy intake (kcal), protein (g), carbohydrate (g), fat (g), and alcohol intake (g) were computed using the ESHA's Food Processor(®). Participants were classified by percent weight loss, maintainers (≥38 %), and regainers (≤30 %)...
July 19, 2016: Canadian Journal of Dietetic Practice and Research
Carolina F Nicoletti, Ana Paula R P de Oliveira, Maria José F Brochado, Marcela A S Pinhel, Bruno A P de Oliveira, Julio S Marchini, José E Dos Santos, Wilson Salgado, Nathalia Moreno Cury, Luiza Ferreira de Araújo, Wilson A Silva, Carla B Nonino
OBJECTIVE: The aim of this study was to investigate whether the Ala55Val and -866G>A polymorphisms of the UCP2 gene are related to weight loss and changes in body composition after bariatric surgery performed by Roux-en-Y gastric bypass (RYGB). METHODS: This longitudinal study enrolled obese patients submitted to RYGB. Data regarding weight (kg), body mass index (kg/m(2)), fat-free mass (FFM; kg), fat mass (kg), weight loss (kg and %), and percent excess weight loss were collected from both preoperative and 1-y postoperative medical records...
August 9, 2016: Nutrition
Matthew Da Silva, Michelle C Cleghorn, Ahmad Elnahas, Timothy D Jackson, Allan Okrainec, Fayez A Quereshy
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a marker that reflects systemic inflammation and organ dysfunction. Its use as a prognostic marker to predict complications following surgery has been recently described in the literature. OBJECTIVES: The objective of our study was to evaluate the use of postoperative day one (POD1) NLR as a predictor of 30-day outcomes in patients undergoing bariatric surgery. SETTING: University Hospital...
October 14, 2016: Surgical Endoscopy
Rinki Murphy, Peter Tsai, Mia Jüllig, Amy Liu, Lindsay Plank, Michael Booth
BACKGROUND: It is unclear whether specific gut microbiota is associated with remission of type 2 diabetes (T2D) after distinct types of bariatric surgery. AIMS: The aim of this study is to examine gut microbiota changes after laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery in obese patients with T2D. METHODS: Whole-metagenome shotgun sequencing of DNA fragments using Illumina HiSeq2000 was obtained from stool samples collected from 14 obese T2D patients pre-operatively (while on very low calorie diet) and 1 year after randomisation to laparoscopic SG (n = 7) or RYGB (n = 7)...
October 13, 2016: Obesity Surgery
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
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