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Gastric bypass complications

Allison R Schulman, Walter Chan, Aiofe Devery, Michele B Ryan, Christopher C Thompson
BACKGROUND AND AIMS: Marginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) are frequently prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules, OCs) might be more easily absorbed than intact capsules (IC)...
October 20, 2016: Clinical Gastroenterology and Hepatology
D Edholm, S Axer, J Hedberg, M Sundbom
BACKGROUND AND AIMS: Unsatisfactory weight loss after gastric bypass or sleeve gastrectomy in super-obese patients (body mass index > 50) is a growing concern. Biliopancreatic diversion with duodenal switch results in greater weight loss, but is technically challenging to perform, especially as a laparoscopic procedure (Lap-DS). The aim of this study was to compare perioperative outcomes of Lap-DS and the corresponding open procedure (O-DS) in Sweden. MATERIAL AND METHODS: The data source was a nationwide cohort from the Scandinavian Obesity Surgery Registry and 317 biliopancreatic diversion with duodenal switch patients (mean body mass index = 56...
October 7, 2016: Scandinavian Journal of Surgery: SJS
John Melissas, Konstantinos Stavroulakis, Vassilis Tzikoulis, Angeliki Peristeri, John A Papadakis, Abdolreza Pazouki, Alireza Khalaj, Ali Kabir
BACKGROUND: The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program. METHODS: Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared. RESULTS: There were steadily increasing numbers of patients underwent SG from 2010 to 2015...
October 20, 2016: Obesity Surgery
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
Jaime Ruiz-Tovar, Pablo Royo, José L Muñoz, Manuel Duran, Elisabeth Redondo, Jose M Ramirez
INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery...
October 7, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Lava Y Patel, Brittany Lapin, Craig S Brown, Thomas Stringer, Matthew E Gitelis, John G Linn, Woody E Denham, Elizabeth Farwell, Stephen Haggerty, Michael B Ujiki
BACKGROUND: Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques...
October 17, 2016: Surgical Endoscopy
Matthew Da Silva, Michelle C Cleghorn, Ahmad Elnahas, Timothy D Jackson, Allan Okrainec, Fayez A Quereshy
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a marker that reflects systemic inflammation and organ dysfunction. Its use as a prognostic marker to predict complications following surgery has been recently described in the literature. OBJECTIVES: The objective of our study was to evaluate the use of postoperative day one (POD1) NLR as a predictor of 30-day outcomes in patients undergoing bariatric surgery. SETTING: University Hospital...
October 14, 2016: Surgical Endoscopy
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
Abdelrahman A Nimeri, Ahmed Maasher, Talat Al Shaban, Elnazeer Salim, Maha Ibrahim
BACKGROUND: Conversion of laparoscopic adjustable gastric banding (LAGB) to other operations is commonly done for significant weight recidivism and complications. METHODS: This is a consecutive series of LAGB converted to RYGB done at the Bariatric and Metabolic Institute (BMI) Abu Dhabi from 2009 to 2013 for weight recidivism. Our preferred approach is to convert LAGB to LRYGB in one stage. All patients undergo upper endoscopy (EGD) and upper gastrointestinal series and are started on clears liquids 2 h after surgery without performing UGI studies...
October 12, 2016: Obesity Surgery
Asad J Choudhry, Nadeem N Haddad, Matthew Martin, Cornelius A Thiels, Elizabeth B Habermann, Martin D Zielinski
OBJECTIVE: Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery. METHODS: We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Fady Saleh, Aristithes G Doumouras, Scott Gmora, Mehran Anvari, Dennis Hong
BACKGROUND: Bariatric surgery centres of excellence are relatively new in Canada and were first started in Ontario in 2009. This study presents short-term outcomes of Canada's largest bariatric collaborative, from Ontario, during its first 3 years. METHODS: We performed a population-based cohort study that included all patients (age ≥ 18) who received a Roux-en-Y gastric bypass or sleeve gastrectomy for the purpose of weight loss from March 2009 to April 2012 within Ontario...
July 2016: CMAJ Open
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan
AIM: To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed. RESULTS: All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum...
October 7, 2016: World Journal of Gastroenterology: WJG
Xiao Du, Si-Qin Zhang, Hong-Xu Zhou, Xue Li, Xiao-Juan Zhang, Zong-Guang Zhou, Zhong Cheng
OBJECTIVES: This 1:1 matched cohort study with 3-year follow-up aimed to compare the safety and efficacy of LSG with LRYGB for morbid obesity patients. METHODS: From 2009 to 2013, patients undergoing LRYGB (n = 63) were matched with LSG (n = 63) by gender, age, and body mass index (BMI). Major complications, BMI, percentage of excess weight loss (%EWL), and obesity-related comorbidities after 6, 12, 24, and 36 months were compared. RESULTS: Hospital stay and major complication rates were comparable, but operative time in LSG was significantly shorter (83...
October 8, 2016: Oncotarget
María Díaz-Tobarra, Norberto Cassinello Fernández, Pablo Jordá Gómez, Mohammad Nebih Nofal, Raquel Alfonso Ballester, Joaquín Ortega Serrano
BACKGROUND: Surgical strategies in patients with BMI > 55 kg/m(2) are not well established. OBJECTIVES: The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic "Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m(2). METHODS: Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m(2) who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG)...
October 9, 2016: Obesity Surgery
Shivakumar Seetharamaiah, Om Tantia, Ghanshyam Goyal, Tamonas Chaudhuri, Shashi Khanna, Jagat Pal Singh, Anmol Ahuja
OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) is one of the most popular bariatric procedure. One anastomosis gastric bypass (OAGB) is rapidly emerging as a safe and effective metabolic procedure. This study aims at comparing the 1-year follow-up results of OAGB and LSG in terms of excess weight loss, complications, resolution of comorbidities, and quality of life. METHODS: A prospective randomized study of results between 100 LSG and 101 OAGB patients was done from 2012 to 2015...
October 7, 2016: Obesity Surgery
Luc Lemmens
BACKGROUND: While gastric bypass has been the treatment of choice for morbid obesity, insufficient weight loss and even weight regain has been observed in a sub-group of patients. Dilatation of the pouch, pouch outlet, and proximal alimentary limb have been suggested to cause weight regain on the long term. The banded gastric bypass surgery has been introduced to overcome this problem. METHODS: Four hundred thirty-two patients (n = 254, non-banded/n = 178, banded-GaBP Ring™) were followed-up for 5 years...
October 7, 2016: Obesity Surgery
Nuria Vilarrasa, Miguel Angel Rubio, Inka Miñambres, Lillian Flores, Assumpta Caixàs, Andrea Ciudin, Marta Bueno, Pedro Pablo García-Luna, María D Ballesteros-Pomar, Marisol Ruiz-Adana, Albert Lecube
BACKGROUND: This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM). METHODS: Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m(2) were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery...
October 5, 2016: Obesity Surgery
Luiz Gustavo de Quadros, Roberto Luiz Kaiser, Manoel Dos Passos Galvão, Josemberg Marins Campos, Marcelo Falcão de Santana, Alvaro Antonio Bandeira Ferraz
Background: A multitude of endoscopic findings post-gastric bypass procedures have been previously reported in the literature, but to our knowledge, no present rules exist that could guide clinicians regarding which findings should be actively sought, once an initial finding is identified. Objective: To identify co-occurrence patterns among endoscopic findings of patients having undergone past gastric bypass procedure. Methods: Our registry involves all consecutive patients undergoing an upper endoscopic evaluation after a gastric bypass procedure...
October 2016: Arquivos de Gastroenterologia
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
Givan F Paulus, Gerdy Konings, Nicole D Bouvy, L W Ernest van Heurn, Jan Willem Greve
BACKGROUND: Adolescent obesity is rapidly becoming more prevalent and is associated with chronic health conditions and psychosocial morbidity. Lifestyle intervention is often ineffective in morbidly obese adolescents, and bariatric surgery is gradually becoming an accepted treatment. However, little is known about long-term results. METHODS: Hospital charts of patients who had undergone gastric banding more than 5 years ago at an age of 18 years or younger, were retrospectively analyzed...
October 5, 2016: Obesity Facts
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