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Ranjan Sudan, Matthew L Maciejewski, Amber R Wilk, Ninh T Nguyen, Jaime Ponce, John M Morton
BACKGROUND: Four current bariatric operations were compared after matching patients for differences at baseline. Operations with greater weight loss and resolution of co-morbidities also incurred more adverse events. Reflux was best treated by gastric bypass and type 2 diabetes with duodenal switch. These results can guide decision making regarding choice of bariatric operation. Relative outcomes of common primary bariatric operations have not been compared previously in a large multisite cohort from surgeons in multiple surgical centers...
January 19, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gladys Witt Strain, Mehyar Hefazi Torghabeh, Michel Gagner, Faith Ebel, Gregory F Dakin, Daniel Connolly, Elizabeth Goldenberg, Alfons Pomp
BACKGROUND: Since biliopancreatic diversion with duodenal switch (BPD/DS) produces hypoabsorption, evaluation of long-term nutrient changes is appropriate. METHODS: Measurements of micronutrients, trace elements, PTH, iron studies, and protein were completed for consented patients at baseline prior to surgery and at yearly intervals. The patients were advised and supplements were adjusted by blood studies with compliance checks. Independent t tests and ANOVAs compared changes between cross-sectional cohorts based on follow-up time from surgery...
February 2, 2017: Obesity Surgery
Amit Surve, Hinali Zaveri, Daniel Cottam, LeGrand Belnap, Austin Cottam, Samuel Cottam
BACKGROUND: The traditional duodenal switch is performed using a Roux-en-Y configuration. This procedure has proven to be the most effective procedure for long-term weight loss and co-morbidity reduction. Recently, stomach intestinal pylorus sparing surgery (SIPS) has been introduced as a simpler and potentially safer variation of the duodenal switch (DS). It is a single anastomosis end-to-side proximal duodeno-ileal bypass with a sleeve gastrectomy. In this study, we compare our outcomes between biliopancreatic diversion with duodenal switch (BPD-DS) and SIPS at 2 years...
December 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Philippe Topart, Guillaume Becouarn, Jacques Delarue
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD/DS) is the most effective bariatric surgical procedure, but major concerns exist about the nutritional consequences. OBJECTIVES: The study reported weight loss and nutritional outcomes of 80 patients with a follow-up of at least 10 years. SETTING: The follow-up was conducted at a university hospital as well as in a private practice institution in France. METHODS: Eighty patients operated on between February 2002 and May 2006 were reviewed...
January 4, 2017: Obesity Surgery
James R Polega, Tyler W Barreto, Kimberly D Kemmeter, Tracy J Koehler, Alan T Davis, Paul R Kemmeter
SETTING: Spectrum Blodgett and Mercy Health St. Mary's hospitals in Grand Rapids, Michigan OBJECTIVE: To compare the 30-day outcomes of laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) to laparoscopic sleeve gastrectomy (SG). BACKGROUND: Laparoscopic BPD/DS has been shown to be superior to SG in terms of excess weight loss. Despite this superiority, BPD/DS accounts for a small percentage of all metabolic surgeries due partly to the perception that BPD/DS has a higher complication rate than SG...
October 31, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Martin Skogar, Ulf Holmbäck, Jakob Hedberg, Ulf Risérus, Magnus Sundbom
BACKGROUND: Concerns for the possibility of an excessive loss of fat-free mass (FFM) and resting metabolic rate (RMR) after bariatric surgery, such as Roux-en-Y gastric bypass (RYGB) and duodenal switch (BPD/DS), have been raised. OBJECTIVES: This study aims to examine body composition and RMR in patients after RYGB and BPD/DS and in non-operated controls. METHODS: Body composition and RMR were studied with Bod Pod and indirect calorimetry in weight-stable RYGB (n = 15) and BPD/DS patients (n = 12) and compared with non-operated controls (n = 17)...
November 24, 2016: Obesity Surgery
Gladys W Strain, Mehyar H Torghabeh, Michel Gagner, Faith Ebel, Gregory F Dakin, Jonathan S Abelson, Daniel Connolly, Alfons Pomp
BACKGROUND: There is limited information on the multiple long-term effects of the biliopancreatic diversion with duodenal switch (BPD/DS). METHODS: Patients who consented to a BPD/DS from 1999 to 2010 were evaluated for weight change, complications, comorbidity resolution, body composition, quality of life, and depressive symptoms during visits at 1, 3,5, 7, and 9 years. Descriptive statistics, analysis of variance, and pair-wise comparisons were calculated for each of the five follow-up cohorts vs...
March 2017: Obesity Surgery
David H St-Pierre, Julie Martin, Hiroyuki Shimizu, Yuko Tagaya, Takahumi Tsuchiya, Simon Marceau, Laurent Biertho, Marjorie Bastien, Sarah-Maude Caron-Cantin, Serge Simard, Denis Richard, Katherine Cianflone, Paul Poirier
CONTEXT: Nesfatin-1 is a neuroendocrine peptide with potent anorexigenic activity in rodents. The potential role of nesfatin-1 on the regulation of energy balance, metabolic functions and inflammation is currently debated in obese humans. In the present study, nesfatin-1 fluctuations and their associations with metabolic factors were investigated in severely obese patients who underwent biliopancreatic diversion with duodenal switch (BPD/DS) and severely obese controls (SOC). BASIC PROCEDURES: Sixty severely obese patients who underwent BPD/DS and 15 SOC (matched for BMI and age) were included in the study...
December 2016: Peptides
Maher El Chaar, Jill Stoltzfus, Leonardo Claros, Maureen Miletics
INTRODUCTION: Bariatric surgery is the only proven and effective long-term treatment for morbid obesity, with laparoscopic sleeve gastrectomy (LSG) being the most commonly performed weight loss procedure in the USA. Despite its safety and efficacy, LSG's association with both de novo and pre-existing gastroesophageal reflux disease (GERD) remains controversial. METHODS: Therefore, this retrospective study determined the incidence, indications, and outcomes of revisional surgery following LSG in adult patients at our institution from 2010 to 2014...
January 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Monica Sethi, Edward Chau, Allison Youn, Yan Jiang, George Fielding, Christine Ren-Fielding
BACKGROUND: There are minimal long-term data on biliopancreatic diversion (BPD) with or without duodenal switch (BPD/DS). OBJECTIVES: To investigate the long-term weight loss, co-morbidity remission, complications, and quality of life after BPD and BPD/DS. SETTING: An academic, university hospital in the United States. METHODS: We conducted a retrospective review of patients who underwent BPD or BPD/DS between 1999 and 2011...
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gladys Witt Strain, Faith Ebel, Jamie Honohan, Michel Gagner, Gregory F Dakin, Alfons Pomp, Dympna Gallagher
OBJECTIVE: Concerns about an excessive loss of fat-free mass (FFM) after bariatric surgery prompted this comparison of operated versus matched nonoperated controls regarding FFM. SETTING: University Hospital and University Research Unit in an urban medical center. METHODS: Body composition with bioelectric impedance (Tanita 310, Tanita Corp, Arlington Heights, IL) was measured approximately 2 years after bariatric surgery in weight stable patients and nonoperated weight stable controls matched for body mass index (BMI), gender, and age...
January 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Philippe Topart, Guillaume Becouarn
BACKGROUND: Insufficient weight loss (percentage of excess weight loss [%EWL]<50%) is observed in approximately 20% of patients after Roux-en-Y gastric bypass (RYGB). Surgical revision can be performed by various procedures including malabsorptive techniques. Conversion to a biliopancreatic diversion with duodenal switch (BPD/DS) remains a complex technique which cannot always be performed as a one-stage procedure. OBJECTIVES: This study evaluates the conversion of RYGB to BPD/DS using a novel gastric reconstruction technique based on a "hybrid sleeve" using the existing gastrojejunal anastomosis of the RYGB...
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Stéfane Lebel, Geneviève Dion, Simon Marceau, Simon Biron, Maud Robert, Laurent Biertho
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) with a 100-cm common channel has been our treatment of choice for morbid obesity since the early 1990s. This procedure offers excellent long-term weight loss but can be associated with significant side effects. OBJECTIVES: To assess the effect on clinical and nutritional parameters of increasing the common channel to 200 cm. SETTINGS: University-affiliated tertiary care center...
June 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Daniel D Tran, Ifeanyi D Nwokeabia, Stephanie Purnell, Syed Nabeel Zafar, Gezzer Ortega, Kakra Hughes, Terrence M Fullum
BACKGROUND: Weight regain has led to an increase in revision of Roux-en-Y gastric bypass (RYGB) surgeries. There is no standardized approach to revisional surgery after failed RYGB. We performed an exhaustive literature search to elucidate surgical revision options. Our objective was to evaluate outcomes and complications of various methods of revision after RYGB to identify the option with the best outcomes for failed primary RYGB. METHOD: A systematic literature search was conducted using the following search tools and databases: PubMed, Google Scholar, Cochrane Clinical Trials Database, Cochrane Review Database, EMBASE, and Allied and Complementary Medicine to identify all relevant studies describing revision after failed RYGB...
July 2016: Obesity Surgery
Philipp Nett, Yves Borbély, Dino Kröll
BACKGROUND: Malabsorptive bariatric surgery requires life-long micronutrient supplementation. Based on the recommendations, we assessed the number of adjustments of micronutrient supplementation and the prevalence of vitamin and mineral deficiencies at a minimum follow-up of 5 years after biliopancreatic diversion with duodenal switch (BPD-DS). METHODS: Between October 2010 and December 2013, a total of 51 patients at a minimum follow-up of 5 years after BPD-DS were invited for a clinical check-up with a nutritional blood screening test for vitamins and minerals...
October 2016: Obesity Surgery
Jens Homan, Janneke Ruinemans-Koerts, E O Aarts, Ignace M C Janssen, Frits J Berends, Hans de Boer
BACKGROUND: Reduced serum vitamin K levels are frequently observed after biliopancreatic diversion (BPD) and BPD with duodenal switch (BPD/DS). The criteria for treatment are not precisely defined. OBJECTIVES: To assess the effects of standardized vitamin K supplementation in patients who develop vitamin K deficiency after BPD or BPD/DS. SETTING: Teaching hospital specializing in bariatric surgery. METHODS: Serum vitamin K levels, clotting times, and vitamin K-dependent coagulation factors were measured after an overnight fast at baseline and then at 4 days and 1, 4, and 52 weeks after the start of vitamin K supplementation in 10 consecutive patients who had developed severe vitamin K deficiency after BPD or BPD/DS...
February 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Laurent Biertho, Frédéric Simon-Hould, Simon Marceau, Stéfane Lebel, Odette Lescelleur, Simon Biron
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) has long been considered as the bariatric procedure with the highest peri-operative and long-term complication rate. However, modern peri-operative care, including laparoscopic and staged-approach, has significantly reduced the complication rate related to this procedure. The goal of this article is to provide an overview of the current outcomes of laparoscopic BPD-DS in a high volume centre. METHODS: All patients who had a laparoscopic BPD-DS with a hand-sewn anastomosis performed between 2011 and 2015 (N = 566) were reviewed...
2016: Annals of Surgical Innovation and Research
Philipp C Nett, Dino Kröll, Yves Borbély
BACKGROUND: Re-sleeve gastrectomy (re-SG) is a possible option to increase weight loss after biliopancreatic diversion with duodenal switch (BPD-DS). We report the feasibility, efficacy and safety of re-SG in patients presenting with long-term weight regain after BPD-DS. METHODS: From October 2010 to December 2013, a total of 17 patients (12 female, 5 male) with a mean age of 42.1 ± 19.4 years underwent re-SG, mainly because of weight regain after BPD-DS. Re-SG was performed laparoscopically over a 32 French stomach tube...
August 2016: Surgical Endoscopy
Audrey Auclair, Julie Martin, Marjorie Bastien, Nadine Bonneville, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, Odette Lescelleur, Jean-Pierre Després, Paul Poirier
BACKGROUND: Severe obesity is often characterized by ectopic fat deposition, which is related to development of type 2 diabetes (T2D). Thus, resolution of T2D may not be linearly associated with weight loss. The importance of ectopic fat reduction after bariatric surgery and T2D resolution is uncertain. OBJECTIVE: The aim of this pilot study is to compare body composition and body fat distribution in severely obese patients with or without T2D after biliopancreatic diversion with duodenal switch (BPD-DS) surgery in relation to diabetes resolution...
August 2016: Obesity Surgery
Salvatore Gentile
The clinical utilization of psychotropic medications in pregnant women represents a significant challenge. Indeed, the risks of untreated severe mental disorders, particularly when complicated by substance-related and addictive disorders, must be carefully balanced against the potential teratogenic risks of pharmacological treatment. In this case, an alcohol addict, diagnosed with borderline personality disorder was treated successfully with several classes of psychotropic agents during the first trimester...
November 2015: Clinical Drug Investigation
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