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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
Ramon Vilallonga, José Manuel Moreno Villares, Diego Yeste Fernández, Raquel Sánchez Santos, Felipe Casanueva Freijo, Francisco Santolaya Ochando, Nuria Leal Hernando, Albert Lecube Torelló, Luis Antonio Castaño González, Albert Feliu, Gontrand Lopez-Nava, Dolores Frutos, Antonio J Torres Garcia, Juan Carlos Ruiz de Adana
PURPOSE: In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain. METHODS: The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies...
October 17, 2016: Obesity Surgery
Everton Cazzo, José Carlos Pareja, Bruno Geloneze, Elinton Adami Chaim, Maria Rita Lazzarini Barreto, Daniéla Oliveira Magro
BACKGROUND: Bariatric surgery usually leads to improvement on the general lipid profile, but its role in the levels of apolipoprotein A-IV (Apo-AIV) is not completely understood. Apo-AIV is a gut-released lipoprotein which is enrolled in satiety regulation and presents anti-inflammatory, anti-atherogenic, and anti-oxidative properties. The objective of this study was to determine the influence of biliopancreatic diversion (BPD) in the levels of Apo-AIV. METHODS: This is a prospective exploratory study which evaluated eight obese individuals with type 2 diabetes mellitus (T2DM) who underwent BPD (Scopinaro operation) and were followed-up for 12 months...
October 15, 2016: Obesity Surgery
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
Emma Gibbons, Amanda Faith Casey, Keith Z Brewster
BACKGROUND: Rates of morbid obesity are higher for individuals with intellectual disability (ID). Individuals with ID may find nutritional guidelines difficult to follow and many face personal and environmental barriers for physical activity. Bariatric surgery may reduce obesity related health comorbidities while promoting sustained weight loss in diverse populations. Yet no study has reviewed the feasibility of conducting bariatric surgery on individuals with ID. OBJECTIVES: To conduct a scoping review of literature on bariatric procedures performed on individuals with ID...
September 16, 2016: Disability and Health Journal
Francesco Greco
BACKGROUND: Recent data show that some patients will have insufficient weight loss or experience weight regain after sleeve gastrectomy. Dilation of the sleeve over time or use of an inadequate technique may contribute to relapse of morbid obesity. Repeat sleeve gastrectomy is the most obvious option but requires stapling of scarred tissue, has a higher risk of leakage, and is prone to re-enlargement with time. We herein describe a simple and innovative technique with which to revise vertical sleeve gastrectomy (VSG) into functional single-anastomosis gastric bypass (f-SAGB)...
October 5, 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...
September 29, 2016: Obesity Surgery
Jordi Pujol Gebelli, Amador Garcia Ruiz de Gordejuela, Almino Cardoso Ramos, Mario Nora, Ana Marta Pereira, Josemberg Marins Campos, Manoela Galvão Ramos, Eduardo Lemos de Souza Bastos, João Batista Marchesini
Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Lars Nelson, Rena C Moon, Andre F Teixeira, Manoel Galvão, Almino Ramos, Muhammad A Jawad
Background: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was introduced into bariatric surgery by Sanchez-Pernaute et al. as an advancement of the biliopancreatic diversion with duodenal switch. Aim: To evaluate the SADI-S procedure with regard to weight loss, comorbidity resolution, and complication rate in the super obese population. Methods: A retrospective chart review was performed on initial 72 patients who underwent laparoscopic or robot-assisted laparoscopic SADI-S between December 17th, 2013 and July 29th, 2015...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Rafael Jacques Ramos, Cláudio Corá Mottin, Letícia Biscaino Alves, Daniela Benzano, Alexandre Vontobel Padoin
Background: There is no consensus on the ideal size of intestinal loops in gastric bypass of bariatric surgeries. Aim: To evaluate the metabolic outcome of patients submitted to gastric bypass with alimentary and biliopancreatic loops of different sizes. Methods: Was conducted a retrospective cohort study in diabetic obese patients (BMI≥35 kg/m2) with metabolic syndrome submitted to gastric bypass. The patients were divided into three groups according to the size of the intestinal loop: group 1, biliopancreatic limb 50 cm length and alimentary limb 100 cm length; group 2 , biliopancreatic limb 50 cm length and alimentary limb 150 cm length; and group 3, biliopancreatic limb 100 cm length and alimentary limb 150 cm length...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive 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...
September 25, 2016: Peptides
Yu-Pu Hong, Wen-Yi Guo, Wei-Xing Wang, Liang Zhao, Ming-Wei Xiang, Fang-Chao Mei, Ablikim Abliz, Peng Hu, Wen-Hong Deng, Jia Yu
Endoplasmic reticulum (ER) stress is a particular process with an imbalance of homeostasis, which plays an important role in pancreatitis, but little is known about how ER stress is implicated in severe acute pancreatitis (SAP) induced pancreatic beta-cell injury. To investigate the effect of 4-phenylbutyric acid (4-PBA) on the beta-cell injury following SAP and the underlying mechanism, twenty-four Sprague-Dawley rats were randomly divided into sham-operation (SO) group, SAP model group, and 4-PBA treatment group...
2016: International Journal of Endocrinology
Ricardo Mohammed, Patrick Fei, John Phu, Megumi Asai, Gintaras Antanavicius
BACKGROUND: Gastroesophageal reflux (GERD) is a symptom frequently found in obese patients, and often is related to the presence of a hiatal hernia (HH). Surgeons may evaluate for the presence of HH on esophagogastroduodenoscopy (EGD). However, preoperative endoscopic presence or absence of a significant HH does not always correlate with intraoperative findings. OBJECTIVE: To compare the rate of detection of repairable HH between clinical, endoscopic, and intraoperative methods SETTING: Independent, university-affiliated teaching hospital METHODS: A retrospective chart review of all consecutive patients who had undergone a primary bariatric procedure sleeve gastrectomy, gastric bypass, or biliopancreatic diversion/duodenal switch with routine preoperative EGD in a single institution from 2009-2013 was performed...
August 17, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Hilde Risstad, Marius Svanevik, Jon A Kristinsson, Jøran Hjelmesæth, Erlend T Aasheim, Dag Hofsø, Torgeir T Søvik, Tor-Ivar Karlsen, Morten W Fagerland, Rune Sandbu, Tom Mala
Importance: Up to one-third of patients undergoing bariatric surgery have a body mass index (BMI) of more than 50. Following standard gastric bypass, many of these patients still have a BMI greater than 40 after peak weight loss. Objective: To assess the efficacy and safety of standard gastric bypass vs distal gastric bypass in patients with a BMI of 50 to 60. Design, Setting, and Participants: Double-blind, randomized clinical parallel-group trial at 2 tertiary care centers in Norway (Oslo University Hospital and Vestfold Hospital Trust) between May 2011 and April 2013...
September 14, 2016: JAMA Surgery
Mitchell S Roslin, Courtney N Cripps
PURPOSE OF REVIEW: Obesity is a worldwide epidemic, having profound effects on Western populations. Bariatric surgery has long been employed to treat obesity and its related comorbidities. Over time, researchers have amassed significant data to support bariatric surgery in the pursuit of treating diabetes mellitus. This review serves to introduce the most recent findings and their relation to the various bariatric surgical options as bariatric surgery will continue to cement itself in the treatment paradigm of diabetes mellitus...
November 2016: Current Opinion in Gastroenterology
Wim Laleman, Kristof Verraes, Werner Van Steenbergen, David Cassiman, Frederik Nevens, Schalk Van der Merwe, Chris Verslype
BACKGROUND AND STUDY AIM: Indeterminate biliary strictures and difficult bile duct stones remain clinically arduous and challenging situations. We aimed to evaluate the utility of the single-operator cholangioscopy (SOC)-system SpyGlass in both conditions in a single-center biliopancreatic interventional unit and in perspective of available aggregated literature. METHODS: Usefulness of SOC was assessed for the above-mentioned indications by means of the combination of successful procedural completion, clinical success and incidence of procedure-related adverse events in our own prospective cohort from 3/2010 to 7/2014 and all available literature till 6/2015...
September 7, 2016: Surgical Endoscopy
Jing Zhou, Zhu Huang, Ning Lin, Weihui Liu, Guan Yang, Dongye Wu, Heda Xiao, Hongyu Sun, Lijun Tang
Our previous study showed that abdominal paracentesis drainage (APD) benefits patients with severe acute pancreatitis (SAP) by delaying or avoiding multiple organ failure. However, the role of APD treatment in SAP-associated lung injury (PALI) remains unclear. Therefore, we investigated the impact of APD on PALI in rats to explore the mechanisms underlying its potential treatment benefits. A drainage tube was inserted into the right lower quadrant of rats immediately after SAP induction via the retrograde infusion of 5% sodium taurocholate into the biliopancreatic duct...
August 29, 2016: Free Radical Biology & Medicine
John Melissas, Halit ErenTaskin, Drakos Peirasmakis, Efstathios Dimitriadis, Marios Papadakis, Seniyye Ulgen Zengin, Volkan Yumuk, Mustafa Taskin
BACKGROUND: The feasibility of a simple side-to-side jejunoileal anastomosis (SJA) in non-morbidly obese individuals to control type 2 diabetes mellitus (T2DM) was studied in six diabetic patients with BMI 28-32. This novel procedure was performed in two Academic Centers and preliminary data is presented. METHODS: SJA bypassing a significant part of the small bowel and diverting food and biliopancretic secretions to the distal ileum was performed laparoscopically in six diabetic patients with BMI 28-32 kg/m(2)...
August 31, 2016: Obesity Surgery
Wenhong Deng, Ablikim Abliz, Sheng Xu, Rongze Sun, Wenyi Guo, Qiao Shi, Jia Yu, Weixing Wang
Recent studies demonstrated that apocynin, a nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) inhibitor, significantly decreased acute pancreatitis‑associated inflammatory and oxidative stress parameters. In addition, apocynin was able to reduce ischemic reperfusion injury‑associated damage; however, the exact effects of apocynin on acute pancreatitis‑associated intestinal mucosal injury have yet to be fully clarified. The present study aimed to investigate the protective effects of apocynin on intestinal mucosal injury in a rat model of severe acute pancreatitis (SAP)...
October 2016: Molecular Medicine Reports
Geltrude Mingrone, David E Cummings
Type 2 diabetes (T2D) is classically characterized by failure of pancreatic β-cell function and insulin secretion to compensate for a prevailing level of insulin resistance, typically associated with visceral obesity. Although this is usually a chronic, progressive disease in which delay of end-organ complications is the primary therapeutic goal for medical and behavioral approaches, several types of bariatric surgery, especially those that include intestinal bypass components, exert powerful antidiabetes effects to yield remission of T2D in most cases...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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