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Dumping syndrome

Kei Hosoda, Keishi Yamashita, Shinichi Sakuramoto, Natsuya Katada, Hiromitsu Moriya, Hiroaki Mieno, Masahiko Watanabe
BACKGROUND: Little is known about postgastrectomy syndrome and quality of life (QOL after laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG). The aim of this study was to assess postgastrectomy syndrome and QOL after LAPPG as compared with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGBI). METHODS: Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaires were sent by mail to 167 patients. To balance the characteristics of the groups, propensity score matching was performed...
October 8, 2016: American Journal of Surgery
A P van Beek, M Emous, M Laville, J Tack
BACKGROUND: Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms. Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia...
October 17, 2016: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
Antonio Luiz de Vasconcellos Macedo, Jairo Tabacow Hidal, Wagner Marcondes, Fernando Concilio Mauro
Postprandial symptoms of neuroglycopenia after bariatric surgery may result as a consequence of endogenous hyperinsulinemic hypoglycemia (nesidioblastosis) not dumping syndrome. Pancreatectomy is an acceptable treatment for this condition. We present the video of a case of near-total distal robotic pancreactectomy for the treatment of nesidioblastosis after Roux-en-Y gastric bypass. Robotic pancreatectomy is an alternative to the treatment of nesidioblastosis after Roux-en-Y gastric bypass.
October 7, 2016: Obesity Surgery
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Yasmin da Silva Chaves, Afrânio Côgo Destefani
Introduction: The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. Objective: Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. Methods: A literature review was performed using the key words: 'dumping syndrome', 'bariatric surgery' and 'rapid dumping syndrome'...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Ram Prakash Narayanan, Akheel A Syed
Bariatric surgery is most commonly carried out in women of childbearing age. Whilst fertility rates are improved, pregnancy following bariatric surgery poses several challenges. Whilst rates of many adverse maternal and foetal outcomes in obese women are reduced after bariatric surgery, pregnancy is best avoided for 12-24 months to reduce the potential risk of intrauterine growth retardation. Dumping syndromes are common after bariatric surgery and can present diagnostic and therapeutic challenges in pregnancy...
October 2016: Obesity Surgery
A Laurenius, M Engström
Early dumping syndrome after gastric bypass surgery due to rapid delivery of hyperosmolar nutrients into the bowel causing intense symptoms is often described as a complication. Twelve patients, mean age 47 years, were interviewed approximately 9 years post-operation. The interviews were audiotaped and transcribed verbatim, followed by an inductive content analysis to reveal patients' experience of the dumping syndrome. The core category 'Dumping syndrome is a positive consequence of Roux-en-Y gastric bypass surgery and a tool to control food intake' was identified based on the following four sub-categories: (i) 'The multidimensional emergence and effects of dumping syndrome', (ii) 'Dumping syndrome as something positive although unpleasant', (iii) 'Developing coping mechanisms and ingenious strategies' and (iv) 'My own fault if I expose myself to dumping syndrome'...
October 2016: Clinical Obesity
Seung-Young Oh, Hyuk-Joon Lee, Han-Kwang Yang
Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3...
June 2016: Journal of Gastric Cancer
Hideo Konishi, Koji Nakada, Masahiko Kawamura, Taizo Iwasaki, Keishiro Murakami, Norio Mitsumori, Katsuhiko Yanaga
BACKGROUND: Postgastrectomy syndrome (PGS) remains a common complication after gastrectomy that affects patients' quality of life. Although impaired gastrointestinal (GI) function by gastrectomy procedures is thought to be the cause, the precise pathophysiology of PGS is yet to be clarified. AIM: The aim of this study was to investigate relationships between GI function and various symptoms or alimentary status in patients after gastrectomy. METHODS: Fifty-one patients who underwent total or distal gastrectomy at least 1 year previously were studied...
November 2016: World Journal of Surgery
Cristina E Requena, Guiomar Pérez-Moreno, András Horváth, Beáta G Vértessy, Luis M Ruiz-Pérez, Dolores González-Pacanowska, Antonio E Vidal
Decitabine (5-aza-2'-deoxycytidine, aza-dCyd) is an anti-cancer drug used clinically for the treatment of myelodysplastic syndromes and acute myeloid leukaemia that can act as a DNA-demethylating or genotoxic agent in a dose-dependent manner. On the other hand, DCTPP1 (dCTP pyrophosphatase 1) and dUTPase are two 'house-cleaning' nucleotidohydrolases involved in the elimination of non-canonical nucleotides. In the present study, we show that exposure of HeLa cells to decitabine up-regulates the expression of several pyrimidine metabolic enzymes including DCTPP1, dUTPase, dCMP deaminase and thymidylate synthase, thus suggesting their contribution to the cellular response to this anti-cancer nucleoside...
September 1, 2016: Biochemical Journal
Christine Stier, Sonja Chiappetta
Dumping syndrome is a long-term postoperative complication of Roux-en-Y gastric bypass procedures. Morphologically, dumping syndrome usually correlates with a dilatation of the gastroenterostomy with accelerated pouch emptying. Conservative therapy includes diet changes, complementary pharmacotherapy and, if symptoms persist, surgical revision. Surgical options include endoscopic, endoluminal surgery to constrict the gastrojejunostomy using a novel endoscopic suturing device (OverStitch(TM), Apollo). In our study, we aimed to assess the viability, safety and efficacy of this procedure in patients with late dumping; 14 patients who had developed late dumping syndrome underwent surgery using an endoscopic suturing technique (OverStitch(TM), Apollo)...
August 2016: Obesity Surgery
Fabian Reche, Adrian Mancini, Anne-Laure Borel, Jean-Luc Faucheron
BACKGROUND: Gastric bypass procedures can potentially lead to middle and long-term complications (Podnos et al. Arch Surg 138(9):957-61, 2003). For several years, Roux-en-Y gastric bypass reversal procedures performed by laparotomy or laparoscopic way have been described in literature (Moon et al. Surg Obes Relat Dis 11(4):821-6, 2015). Major complications are anastomotic ulcers, anastomotic complications or functional disorder such as dumping syndrome, hypocalcemia, severe hypoglycemia, and malnutrition (Moon et al...
August 2016: Obesity Surgery
Saeed Shoar, Thu Nguyen, Mel A Ona, Madhavi Reddy, Sury Anand, Mohammed J Alkuwari, Alan A Saber
BACKGROUND: Due to the large number of Roux-en-Y gastric bypass surgeries performed over the last decade, reversal of the bypass to normal anatomy has been increasingly reported. SETTING: University affiliated Teaching Hospital, United States. OBJECTIVES: The aim of this systematic review was to summarize the literature data regarding the indications, technical considerations, and outcomes of gastric bypass reversal. METHODS: PubMed/MEDLINE search was conducted for articles reporting reversal of gastric bypass to normal anatomy...
February 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
M Ramadan, M Loureiro, K Laughlan, R Caiazzo, A Iannelli, L Brunaud, S Czernichow, M Nedelcu, D Nocca
Background. Bariatric surgery is an important field of surgery. An important complication of bariatric surgery is dumping syndrome (DS). Aims. To evaluate the incidence of DS in patients undergoing bariatric surgery. Methods. 541 patients included from 5 nutrition and bariatric centers in France underwent either LSG or LRYGB. They were evaluated at 1 month (M1) and 6 months (M6) postoperatively by an interview and completion of a dumping syndrome questionnaire. Results. 268 patients underwent LSG (Group A) and 273 underwent LRYGB...
2016: Gastroenterology Research and Practice
Yong Li, Jiabin Zheng
Gastric cancer is one of the most common digestive malignant tumors. More and more elderly gastric cancer patients are diagnosed and need to undergo surgical treatment as the population ages. Since the elderly patients decrease in organ function and increase in internal diseases, the tolerance to anesthesia and surgery is poor. As a result, the incidence of surgical and postoperative complications is obviously higher. Complications can be divided into surgical complications and non-surgical related complications...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sachie Hirose, Yasuyuki Iwahashi, Akane Seo, Michitaka Sumiyoshi, Tetsuya Takahashi, Yoshikazu Tamori
Reactive hypoglycemia induced by late dumping syndrome is often observed after gastrectomy. However, no effective therapy has yet been fully established. We herein describe a case in which concurrent therapy with a low-carbohydrate diet using low-glycemic-index food and an alpha-glucosidase inhibitor, miglitol, very effectively ameliorated the postprandial fluctuations in the blood glucose and plasma insulin levels in a patient with reactive hypoglycemia due to late dumping syndrome following total gastrectomy...
2016: Internal Medicine
Bettina K Wölnerhanssen, Anne Christin Meyer-Gerspach, Thomas Peters, Christoph Beglinger, Ralph Peterli
BACKGROUND: After laparoscopic Roux-en-Y gastric bypass (LRYGB), many patients suffer from dumping syndrome. Oral glucose tolerance tests are usually carried out with 50-75 g of glucose. The aim of this study was to examine whether minimal glucose loads of 10 g and 25 g induce a reliable secretion of satiation peptides without dumping symptoms after LRYGB. In addition, lean and obese controls were examined. OBJECTIVE: The objective of this study was to determine the effects of low oral glucose loads on incretin release and gastric emptying...
November 27, 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Muffazal Lakdawala, Peter Limas, Shilpa Dhar, Carlyne Remedios, Neha Dhulla, Amit Sood, Aparna Govil Bhasker
INTRODUCTION: Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision. We report the 1-year outcomes of five patients who underwent laparoscopic conversion of RYGB to sleeve gastrectomy during surgical revision. METHODS: Mean age was 38.8 ± 9.1 years. Mean BMI at primary surgery was 57...
May 2016: Asian Journal of Endoscopic Surgery
Miwako Ohgishi, Yuko Horiba, Kenji Watanabe
Cancer-related gastrectomy can cause post-gastrectomy syndrome, which includes weight loss, dumping syndrome, and reflux esophagitis and negatively affects the quality of life. Comprehensive and individualized patient management is required; however, there is a limit to Western medicine's ability to treat these symptoms. Kampo, a traditional Japanese medicine, adapts treatments to each individual's symptoms and constitution. We treated a 68-year-old male patient with post-gastrectomy syndrome using senpukukataishasekito, a Kampo medicine...
January 2016: Global Advances in Health and Medicine: Improving Healthcare Outcomes Worldwide
Sophie Fromhold-Treu, Georg Lamprecht
This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain...
February 2016: Deutsche Medizinische Wochenschrift
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