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Gastric bypass complications

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https://www.readbyqxmd.com/read/28098067/renal-function-in-type-2-diabetes-following-gastric-bypass
#1
Adrian T Billeter, Stefan Kopf, Martin Zeier, Katharina Scheurlen, Lars Fischer, Thilo M Schulte, Hannes G Kenngott, Barbara Israel, Philipp Knefeli, Markus W Büchler, Peter P Nawroth, Beat P Müller-Stich
BACKGROUND: Metabolic surgery for obese patients with type 2 diabetes (T2D) yields short- and long-term remission rates of 60-90%. Its effects on diabetesassociated complications such as neuropathy and nephropathy have not been well studied to date. Hardly any data are available on this subject with respect to moderately obese patients (body mass index [BMI] 25-35 kg/m2) with insulin-dependent T2D. Our previous studies suggest that, in such patients, treatment with a Roux-en-Y gastric bypass (RYGB) improves diabetic neuropathy...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28091893/endoscopic-management-of-eroded-bands-following-banded-gastric-bypass-with-video
#2
Hany Shehab, Khaled Gawdat
BACKGROUND: Banded-gastric bypass is a highly effective bariatric procedure, yet the possibility of band erosion remains a significant drawback. Surgical removal of eroded bands may be associated with significant morbidity. In this study, we assess the efficacy and safety of a solely peroral endoscopic approach for the management of eroded bands in patients with a banded-gastric bypass. MATERIALS AND METHODS: Starting January 2012, all patients with banded-gastric bypass and an eroded band were subjected to an attempt at peroral endoscopic removal using endoscopic scissors and/or argon plasma coagulation (APC), regardless of the circumference of band eroding inside the lumen...
January 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28088126/severe-hypoalbuminemia-and-steatohepatitis-leading-to-death-in-a-young-vegetarian-female-8-months-after-mini-gastric-bypass-a-case-report
#3
Mohammad Kermansaravi, Mohammad Reza Abdolhosseini, Ali Kabir, Abdolreza Pazouki
BACKGROUND: Hypoalbuminemia is an important complication after Mini Gastric Bypass (MGB) and is more frequent in vegetarians, diabetic nephropathy, and alcoholic and liver disease patients. The patients must be followed in regular intervals and serum albumin must be checked in every visit after MGB. Hypoalbuminemia must be prevented by good protein regimes. CASE SUMMARY: A 29 years old female was admitted 8 month after Laparoscopic Mini Gastric Bypass with malaise, dyspnea, icter, nausea, vomiting, diarrhea and edema of extremities from 2 weeks before admission...
December 11, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28077412/microvascular-outcomes-after-metabolic-surgery-moms-in-patients-with-type-2-diabetes-mellitus-and-class-i-obesity-rationale-and-design-for-a-randomised-controlled-trial
#4
Ricardo Vitor Cohen, Tiago Veiga Pereira, Cristina Mamédio Aboud, Pedro Paulo de Paris Caravatto, Tarissa Beatrice Zanata Petry, José Luis Lopes Correa, Carlos Aurélio Schiavon, Mariangela Correa, Carlos Eduardo Pompílio, Fernando Nogueira Quirino Pechy, Carel le Roux
INTRODUCTION: There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). PURPOSE: The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069786/portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-for-morbid-obesity
#5
Leslie S Anewenah, Mohammed Asif, Richard Francesco, Prashanth Ramachandra
Portomesenteric vein thrombosis (PMVT) is a rare, life-threatening pathology associated with increased prevalence in laparoscopic sleeve gastrectomy (LSG) versus other gastric bypass procedures. Gaining popularity, LSG is becoming the first choice of patients and physicians alike due to its low complication profile compared to the gastric bypass procedure. We present the case of a 34-year-old woman who underwent an uncomplicated LSG for the treatment of morbid obesity, and presented on postoperative day 13 with PMVT...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28065734/laparoscopic-roux-en-y-gastric-bypass-in-adolescents-with-severe-obesity-amos-a-prospective-5-year-swedish-nationwide-study
#6
Torsten Olbers, Andrew J Beamish, Eva Gronowitz, Carl-Erik Flodmark, Jovanna Dahlgren, Gustaf Bruze, Kerstin Ekbom, Peter Friberg, Gunnar Göthberg, Kajsa Järvholm, Jan Karlsson, Staffan Mårild, Martin Neovius, Markku Peltonen, Claude Marcus
BACKGROUND: Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study...
January 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28055029/gastrointestinal-transcriptomic-response-of-metabolic-vitamin-b12-pathways-in-roux-en-y-gastric-bypass
#7
Priscila Sala, Giliane Belarmino, Raquel S Torrinhas, Natasha M Machado, Danielle C Fonseca, Graziela R Ravacci, Robson K Ishida, Ismael F M S Guarda, Eduardo G de Moura, Paulo Sakai, Marco A Santo, Ismael D C G da Silva, Claudia C A Pereira, Angela F Logullo, Steven Heymsfield, Daniel Giannella-Neto, Dan L Waitzberg
OBJECTIVES: Vitamin B12 (B12) deficiency after Roux-en-Y gastric bypass (RYGB) is highly prevalent and may contribute to postoperative complications. Decreased production of intrinsic factor owing to gastric fundus removal is thought to have a major role, but other components of B12 metabolism may also be affected. We evaluated changes in the expression levels of multiple B12 pathway-encoding genes in gastrointestinal (GI) tissues to evaluate the potential roles in contributing to post-RYGB B12 deficiency...
January 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28054294/treatment-of-common-bile-duct-stones-in-gastric-bypass-patients-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#8
Nina A Frederiksen, Louise Tveskov, Frederik Helgstrand, Lars Naver, Andrea Floyd
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Various techniques to access the biliary tree have been described. The techniques are characterised by complexity and varying results. The aim of the present study was to assess both feasibility and outcome of laparoscopic-assisted transgastric ERCP in patients with gastric bypass...
January 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#9
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28050755/effect-of-major-gastrointestinal-tract-surgery-on-the-absorption-and-efficacy-of-direct-acting-oral-anticoagulants-doacs
#10
REVIEW
Hakeam A Hakeam, Nasser Al-Sanea
Direct-acting oral anticoagulants (DOACs) have been introduced as alternatives to warfarin for stroke prevention in non-valvular atrial fibrillation and for treatment of venous thromboembolism. Many patients undergoing major gastrointestinal resections or bypass receive anticoagulants for various indications, including the treatment of thrombotic complication of surgery and prevention of visceral vessels events recurrence. DOACs have a wide therapeutic range that allows fixed dosing determined based on studies conducted in healthy subjects with normal absorptive capacity...
January 3, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28049511/prepancreatic-postduodenal-portal-vein-a-case-report-and-review-of-the-literature
#11
Naeem Goussous, Steven C Cunningham
BACKGROUND: Prepancreatic postduodenal portal vein is extremely rare, with only 13 cases reported in the literature. CASE PRESENTATION: A 55-year-old white woman presented to our emergency department with abdominal pain. She underwent a computed tomography of her abdomen, which showed a portal vein coursing anterolaterally to her pancreas and posteriorly to the first portion of her duodenum, constituting a prepancreatic postduodenal portal vein. Imaging revealed choledocholithiasis, requiring endoscopic sphincterotomy, but due to a history of a gastric bypass procedure, she was lost to follow-up after being referred to an advanced endoscopist...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28035521/postoperative-outcomes-of-laparoscopic-bariatric-surgery-in-older-obese-patients-a-matched-case-control-study
#12
Damien Bergeat, David Lechaux, Adil Ghaina, Ronan Thibault, Vianney Bouygues
BACKGROUND: Laparoscopic bariatric surgery (LBS) in older obese patients remains debated regarding postoperative outcomes. OBJECTIVES: The aim of this case-control study is to evaluate global results of LBS in patients ≥60 years (yr) with a matched case control study. METHODS: All patients ≥60 years who benefited from LBS in our center between January 2009 and January 2014 were included in this retrospective study. They were matched (1:2) to patients <40 and 40-59 years on BMI, surgical procedure and year, and history of previous LBS...
December 29, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/28028750/early-clinical-experience-with-the-da-vinci-xi-surgical-system-in-general-surgery
#13
Monika E Hagen, Minoa K Jung, Frederic Ris, Jassim Fakhro, Nicolas C Buchs, Leo Buehler, Philippe Morel
The da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2014 to facilitate minimally invasive surgery. Novel features are targeted towards facilitating complex multi-quadrant procedures, but data is scarce so far. Perioperative data of patients who underwent robotic general surgery with the da Vinci Xi system within the first 6 month after installation were collected and analyzed. The gastric bypass procedures performed with the da Vinci Xi Surgical System were compared to an equal amount of the last procedures with the da Vinci Si Surgical System...
December 27, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28027914/vitamin-d-and-intestinal-calcium-transport-after-bariatric-surgery
#14
REVIEW
Anne L Schafer
Bariatric surgery is a highly effective treatment for obesity, but it may have detrimental effects on the skeleton. Skeletal effects are multifactorial but mediated in part by nutrient malabsorption. While there is increasing interest in non-nutritional mechanisms such as changes in fat-derived and gut-derived hormones, nutritional factors are modifiable and thus represent potential opportunities to prevent and treat skeletal complications. This review begins with a discussion of normal intestinal calcium transport, including recent advances in our understanding of its regulation by vitamin D, and areas of continued uncertainty...
December 24, 2016: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28017813/association-between-state-medical-malpractice-environment-and-postoperative-outcomes-in-the-united-states
#15
Christina A Minami, Catherine R Sheils, Emily Pavey, Jeanette W Chung, Jonah J Stulberg, David D Odell, Anthony D Yang, David J Bentrem, Karl Y Bilimoria
BACKGROUND: The U.S. medical malpractice system assumes that the threat of liability should deter negligence but it is unclear whether malpractice environment impacts healthcare quality. We thus sought to explore the association between state malpractice environment and post-operative complication rates. STUDY DESIGN: This observational study included Medicare fee-for-service beneficiaries undergoing one of the following surgeries in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28012332/laparoscopic-management-of-severe-reflux-after-sleeve-gastrectomy-using-the-linx-%C3%A2-system-technique-and-one-year-follow-up-case-report
#16
Abdelkader Hawasli, Mark Tarakji, Moayad Tarboush
INTRODUCTION: Management of severe reflux after sleeve gastrectomy (SG) usually requires converting to Roux-en-y gastric bypass (RYGB). We present a case of managing this problem using the LINX(®) system. PRESENTATION OF CASE: In February 2015, we performed a laparoscopic placement of LINX(®) system to treat severe reflux after sleeve gastrectomy on a 25-year-old female. The operative time was 47min. There were no intra or postoperative complications. The hospital stay was one day...
November 29, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28012018/bilateral-insufficiency-hip-fractures-after-bariatric-surgery
#17
V Barro, J H Nuñez, A Gargallo-Margarit, A Sallent, M Aguilar, A Hernandez
Bariatric surgery is one of the most common surgeries within developed countries due to the increase in morbid obesity that has been observed in the past decades. The short-term alterations in the metabolism of calcium and vitamin D are well known after these procedures; however, the clinical and biochemical consequences may not be detected for years or even remain undiagnosed. We present the first case of bilateral insufficiency hip fracture after years of bariatric surgery. Although this is a long-term and rare complication, with the high number of gastric bypass performed in the past years, the number of these cases could increase with time...
December 23, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/28008465/five-year-results-of-laparoscopic-sleeve-gastrectomy-for-the-treatment-of-severe-obesity
#18
David Nocca, Marcelo Loureiro, El Mehdi Skalli, Marius Nedelcu, Audrey Jaussent, Melanie Deloze, Patrick Lefebvre, Jean Michel Fabre
BACKGROUND: Since 2011, the most used bariatric technique in France has been the sleeve gastrectomy. There are still few studies exploring the medium and long-term results of this technique. OBJECTIVE: To describe medium-long-term (5 years) results of a cohort of CHU Montpellier experience in sleeve gastrectomy for morbid obesity. METHODS: All patients that underwent laparoscopic sleeve gastrectomy (LSG) from January 2005 to June 2013 were included in this study...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28008162/endoscopic-approach-for-major-complications-of-bariatric-surgery
#19
Moon Kyung Joo
As lifestyle and diet patterns have become westernized in East Asia, the prevalence of obesity has rapidly increased. Bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB), are considered the first-line treatment option in patients with severe obesity. However, postoperative complications have increased and the proper management of these complications, including the use of endoscopic procedures, has become important. The most serious complications, such as leaks and fistulas, can be treated with endoscopic stent placement and injection of fibrin glue, and a novel full-thickness closure over-the-scope clip (OTSC) has been used for treatment of postoperative leaks...
December 23, 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/28006717/jejunojejunostomy-intussusception-after-gastric-bypass-case-report-of-a-rare-but-serious-complication
#20
Ajay Kohli, Lily Gutnik, Danielle Berman, Anil Narula
Obesity, and the comorbidities associated with it, have become endemic within society. Roux-en-Y gastric bypass (RYGB) surgery is an increasingly common procedure with medical and cosmetic benefits (Li et al., 2014) [1]. However, as the case volume increases so do the rate of uncommon complications and it is imperative for surgeons to be aware of management guidelines of these complications. We present a case of Retrograde intussusception (RI) which is a rare complication status post RYGB. It is most commonly reported at the jejunojejunostomy (JJ) site, and it is hypothesized to be secondary to an antiperistaltic (retrograde) telescoping of the common limb going into the jejunal anastomosis (Varban et al...
December 7, 2016: International Journal of Surgery Case Reports
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