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Gastric anastomosis

Tetsu Fukunaga, Yuji Ishibashi, Shinichi Oka, Satoshi Kanda, Yukinori Yube, Yoshinori Kohira, Yuta Matsuo, Osamu Mori, Shinya Mikami, Takeharu Enomoto, Takehito Otsubo
BACKGROUND: Billroth I reconstruction is a means of anastomosis that is widely performed after surgical resection for distal gastric cancer. Interest has grown in totally laparoscopic gastrectomy, and several methods for totally laparoscopic performance of Billroth I reconstruction have been reported. However, the methods are cumbersome, and postoperative complications such as twisting at the site of anastomosis and obstruction due to stenosis have arisen. We developed an augmented rectangle technique (ART) by which the anastomosis is created laparoscopically with the use of three automatic endoscopic linear staplers, and the resulting anastomotic opening is wide and less likely to become twisted or stenosed...
June 18, 2018: Surgical Endoscopy
Dvir Froylich, Matthew Davis, Gautam Sharma, Tammy Fouse, Philip Schauer, Stacy Brethauer
BACKGROUND: Gastrojejunostomy revision after gastric bypass surgery is a challenging procedure that requires advanced skills. The air-leak test was performed to identify gastrojejunostomy leaks. Omental patch seal technique is a well-known treatment of perforated gastrojejunostomy ulcers (Surg Obes Relat Dis 4:423-8, 2012; Surg Endosc 2:384-9, 2013; Surg Endosc 11:2110, 2007). METHODS: We present a case of a 40-year-old female, who underwent laparoscopic gastric bypass 6 years prior and subsequently developed marginal ulcer, resulting in chronic gastrojejunostomy stricture...
June 18, 2018: Obesity Surgery
Manish Parikh, Dan Eisenberg, Jason Johnson, Maher El-Chaar
The following review is being published by the American Society for Metabolic and Bariatric Surgery in response to numerous inquiries made to the Society by patients, physicians, society members, hospitals, and others regarding one-anastomosis gastric bypass as a primary treatment for obesity or metabolic disease. The review is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence available at this time. The review is not intended as, and should not be construed as, stating or establishing a local, regional, or national standard of care...
May 9, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Y Kumagai, S Hatano, J Sobajima, T Ishiguro, M Fukuchi, K-I Ishibashi, E Mochiki, Ya Nakajima, H Ishida
By examining the reconstructed gastric tube during esophagectomy using indocyanine green fluorescence (ICG) angiography, we have established a '90-second rule' to confirm good blood perfusion at the anastomosis site. We examined the surgical outcome (rate of anastomotic leakage) of 70 consecutive patients who underwent esophagectomy with gastric tube reconstruction using ICG fluorescence angiography. All of the anastomoses were made in the area where less than 90 seconds was needed for enhancement using ICG fluorescence angiography (i...
June 12, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Shohei Eto, Masashi Ishikawa, Michihito Asanoma, Yoshihiko Tashiro, Kazuo Matsuyama, Takehito Oshio
A 62-year-old man underwent endoscopic mucosal resection for early gastric cancer. The follow-up computed tomography revealed biliary dilatation. The tumor was located in the lower bile duct with biliary dilatation, and no evidence of metastasis in other organs was noted. The patient underwent subtotal stomach-preserving pancreatoduodenectomy with pancreaticogastrostomy and Billroth I anastomosis. At 13 months after the operation, gastrointestinal endoscopy revealed a tumor lesion in the pancreaticogastrostomy site...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Chong Zhong Liu, Jian Kang Zhu, Qianqian Xu, Feng Yue Liu, Ya Dong Wang, Min Zhu
BACKGROUND: Postoperative pancreatic fistula (POPF) is the most common critical complication after pancreaticoduodenectomy (PD) and a primary reason for increased mortality and morbidity after PD. To perform a safe pancreaticojejunostomy (PJ), a fast and simple technique of duct-to-mucosa PJ with one-layer suture was devised at our institution. MATERIALS AND METHODS: We conducted a retrospective analysis of 81 successive cases of PD performed at our hospital from March 2012 to August 2016...
June 8, 2018: International Journal of Surgery
Matteo Melloni, Veronica Lazzari, Emanuele Asti, Luigi Bonavina
Bile reflux into the gastric stump and then into the oesophagus is a common event after distal gastrectomy and Billroth II reconstruction. In addition to typical symptoms of nausea, epigastric pain and bile vomiting, acid reflux can also occur in patients with concomitant hiatus hernia and lower oesophageal sphincter incompetency. Diverting the bile away from the oesophagus by conversion into a Roux-en-Y anastomosis or by completion gastrectomy and Roux-en-Y esophagojejunostomy have so far represented the mainstay of treatment...
June 8, 2018: BMJ Case Reports
Y Goto, N Shirahama, S Sasaki, R Kawahara, H Sakai, H Ishikawa, T Hisaka, T Ogata, M Yasunaga, Y Akagi, H Tanaka, K Okuda
BACKGROUND: Some literature has reported on endovascular treatment for very early hepatic artery stenosis (HAS; within 2 weeks after liver transplantation, and has deemed endovascular treatment to be a contraindication because out of serious complications associated with the procedure. We report on 2 cases of very early HAS successfully treated with endovascular treatment after living-donor liver transplantation (LDLT). CASE 1: A 54-year-old woman underwent LDLT with a left liver graft...
June 2018: Transplantation Proceedings
Sebastien Michiels, Caroline Delier, Patrick Philippart
INTRODUCTION: Small bowel intussusception is a rare complication after Roux-en-Y gastric bypass (RYGB) whose incidence tends to increase. This rising could be explained by an increasing bariatric surgery over the last two decades and by a better recognition of this potential complication. PATIENT AND METHODS: We report a case of jejunojejunal intussusception in 33-year-old woman 2 years following a laparoscopic RYGB. She was taken to the operating room for exploratory laparotomy...
June 7, 2018: Acta Chirurgica Belgica
Sonja Chiappetta, Hannah M Schaack, Bettina Wölnerhannsen, Christine Stier, Simone Squillante, Rudolf A Weiner
BACKGROUND: Obesity and metabolic surgery is known to improve chronic inflammatory status. Whether improvement is related to anatomical changes or weight loss is still to debate. OBJECTIVE: The aim of this clinical trial is to compare the different bariatric procedures sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and One-anastomosis gastric bypass (OAGB), pertaining to their effects on inflammation markers. METHODS: Patients who underwent SG, RYGB, or OAGB as a primary treatment for severe obesity were included...
June 6, 2018: Obesity Surgery
Abib Diop, Ousmane Thiam, Mouhamadou Lamine Guèye, Mamadou Seck, Alpha Oumar Touré, Mamadou Cissé, Madieng Dieng
We conducted a retrospective study of 15 patients with complicated Meckel diverticula treated in the emergency surgery at the Aristide Le Dantec Hospital, Dakar, over a period of 13 years (January 2003-June 2016). The study included 10 men and 5 women, whose average age was 27.8 years, ranging between 1 months and 73 years. The two main circumstances of detection were occlusive syndrome and peritoneal irritation. Emergency laparotomy allowed clinicians to affirm the involvement of Meckel diverticulum in the clinical picture...
2018: Pan African Medical Journal
Payal K Gurnani, Allison Bohlmann, Robert J March
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used as a bridge to cardiac recovery in patients following a major cardiac event. There is a lack of literature surrounding prolonged use of eptifibatide and optimal dosing during ECMO. This case report describes our experience with extended durations and standard dosing of eptifibatide in the setting of ECMO. CASE: A 40-year-old male with a history of Marfan's syndrome, aortic root and ascending aortic aneurysm status post a modified Bentall with a St...
June 1, 2018: Perfusion
Shigeyuki Yoshiyama, Yuji Toiyama, Takashi Ichikawa, Tadanobu Shimura, Hiromi Yasuda, Jun-Ichiro Hiro, Masaki Ohi, Toshimitsu Araki, Masato Kusunoki
The cause of jejunojejunal intussusception, a rare complication after Roux-en-Y gastric surgery, remains unclear. Here, we present a case of retrograde jejunojejunal intussusception that occurred after laparoscopic distal gastrectomy with Roux-en-Y reconstruction. A 51-year-old woman who had undergone laparoscopic distal gastrectomy and Roux-en-Y reconstruction for early gastric cancer 6 years previously was admitted to our hospital with abdominal pain. Abdominal CT revealed the "target sign," and she was diagnosed as having small bowel intussusception...
June 5, 2018: Asian Journal of Endoscopic Surgery
Tarek Abouzeid Osman Abouzeid, Ahmed Adel Ain Shoka, Karim Sabry Abd Elsamee Atia
BACKGROUND/AIMS: Type 2 diabetes mellitus (T2DM) is considered a chronic progressive incurable metabolic disease. Single-anastomosis gastric bypass (SAGB) has proved to be effective in obese patients, yet its impact on non-obese diabetics is not extensively studied. The aim is to determine the anthropometric and glycemic outcomes of SAGB as a proposed line of treatment for T2DM patients with body mass index (BMI) 25-30 kg/m2 . METHODS: From November 2013 to March 2016, a prospective study has been conducted at Ain-Shams University Hospitals on 17 consecutive patients who have undergone SAGB...
June 2, 2018: Asian Journal of Surgery
Francesco Paolo Caronia, Ettore Arrigo, Andrea Valentino Failla, Francesco Sgalambro, Giorgio Giannone, Attilio Ignazio Lo Monte, Massimo Cajozzo, Mario Santini, Alfonso Fiorelli
A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis...
April 2018: Journal of Thoracic Disease
Xuefeng Xu, Yang Lv, Lei Zhang, Baobao Xin, Jian-Ang Li, Dansong Wang, Tiantao Kuang, Wenhui Lou, Dayong Jin
Optimized pancreaticojejunostomy anastomosis was used to investigate the effects on the incidence rate of postoperative complications in pancreaticoduodenectomy. The data of 250 patients who underwent pancreaticoduodenectomy between August 2011 and December 2015 were analyzed; all surgery was performed by a single team. The first 100 surgeries were performed using traditional pancreaticojejunostomy anastomosis, whereas the next 150 patients underwent novel pancreaticojejunostomy anastomosis (the experimental group)...
May 2018: Oncology Letters
M Robert, E Pelascini, G Poncet, A Pasquer
No abstract text is available yet for this article.
May 26, 2018: Journal of Visceral Surgery
Mohammad Kermansaravi, Mohammad Kazazi, Abdolreza Pazouki
Background: One anastomosis gastric bypass (OAGB) is now considered as an appropriate alternative for Roux-en-Y gastric bypass (RYGB) with some advantages such as absence of risk for internal hernia (IH). But, is really the risk of IH equal zero after OAGB? Case Summary . A 37-year-old male was admitted due to severe abdominal crampy pain, nausea, vomiting, and obstipation. He had chronic and intermittent abdominal pain from 2 years after OAGB. With high suspicion of complete obstruction, the exploratory laparoscopy was performed...
2018: Case Reports in Surgery
Austin Cottam, Daniel Cottam, Hinali Zaveri, Samuel Cottam, Amit Surve, Walter Medlin, Christina Richards
BACKGROUND: For many years, the Roux-en-Y Gastric Bypass (RYGB) was considered a good balance of complications and weight loss. According to several short-term studies, single anastomosis duodenal switch or stomach intestinal pylorus sparing surgery (SIPS) offers similar weight loss to RYGB with fewer complications and better diabetes resolution. No one has substantiated mid-term complication and nutritional differences between these two procedures. This paper seeks to compare complication and nutritional outcomes between RYGB and SIPS...
May 22, 2018: Obesity Surgery
Volodymyr O Shaprynskyi, Yevhen V Shaprynskyi, Yaroslav V Karyi, Serhii A Lysenko, Oleg O Vorovskyi, Andrii I Semenenko
OBJECTIVE: Introduction: Nowadays operative treatment of corrosive esophageal strictures remains one of the difficult and unsolved problems in surgery. The level of postoperative complications such as anastomotic leak (develops in 7-30% of cases), infections, pneumonia, pleural empyema, mediastinitis, peritonitis, postoperative corrosive strictures is still rather high. The aim of our work was to improve the results of surgical treatment of patients with corrosive esophageal strictures by analyzing and refining on conservative therapy options as well as differentiated approach to each operative treatment method...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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