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Gastric bypass complications

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https://www.readbyqxmd.com/read/29770188/retrograde-jejunojejunal-intussusception-in-a-pregnant-female-after-laparoscopic-roux-en-y-gastric-bypass
#1
Khuram Khan, Saqib Saeed, Amrita Persaud, Mohammad Sbeih, Sanjiv Gray, Leaque Ahmed
Adult intussusception is a rare complication after laparoscopic Roux-En-Y gastric bypass (LRYGB) surgery. Incidence of intussusception is on the rise as the demand of bariatric surgeries is increased to treat morbid obesity. Among the bariatric surgeries, LRYGB gastric bypass results in significantly higher weight loss with thinning of the mesentery resulting in increased risk for intussusception. Majority of intussusception cases after gastric bypass have been reported in non-pregnant patients. We report a case of retrograde jejunojejunal intussusception in 6 weeks pregnant female following laparoscopic gastric bypass, which was diagnosed with abdominal magnetic resonance imaging and managed successfully with resection and revision of the anastomosis...
May 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29766309/perioperative-outcomes-and-anesthetic-considerations-of-robotic-bariatric-surgery-in-a-propensity-matched-cohort-of-super-obese-and-super-super-obese-patients
#2
Katherine D Gray, Alfons Pomp, Gregory Dakin, Sonia Amanat, Zachary A Turnbull, Jon Samuels, Cheguevara Afaneh
BACKGROUND: The use of the robotic platform has not been well established in patients with super obesity (SO; body mass index, BMI ≥ 50) and super-super obesity (SSO, BMI ≥ 60). We aimed to determine safety and feasibility of robotic bariatric surgery in this cohort. METHODS: Review of a prospectively maintained database was performed of consecutive patients undergoing robotic bariatric surgery between 2015 and 2017. Propensity score analysis with 1:2 nearest neighbor matching was performed to control for baseline characteristics and procedure type...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29766305/evaluation-of-vte-prophylaxis-and-the-impact-of-alternate-regimens-on-post-operative-bleeding-and-thrombotic-complications-following-bariatric-procedures
#3
Maria S Altieri, Jie Yang, Janos Hajagos, Konstantinos Spaniolas, Jihye Park, Antonios P Gasparis, Andrew T Bates, Salvatore Docimo, Mark Talamini, A Laurie Shroyer, Aurora D Pryor
BACKGROUND: Studies examining utilization and impact of venous thromboembolism (VTE) chemoprophylaxis for patients undergoing bariatric surgery are limited. Determination of the optimal prophylactic regimen to minimize complications is crucial. METHODS: The Cerner Health Facts database from 2003 to 2013 was queried using ICD-9 codes to identify patients undergoing laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB). VTE chemoprophylaxis regimens were divided into pre-operative alone (PreP), post-operative alone (PostP), both pre-operative and post-operative (PPP), or no prophylaxis (NP)...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29764908/management-of-endocrine-disease-which-metabolic-procedure-comparing-outcomes-in-sleeve-gastrectomy-and-roux-en-y-gastric-bypass
#4
Adrian T Billeter, Javier de la Garza Herrera, Katharina M Scheurlen, Felix Nickel, Franck Billmann, Beat Müller-Stich
Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities have a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effect therapy for severe obesity achieving long-lasting weight loss...
May 15, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29755786/laparoscopic-assisted-transgastric-ercp-a-single-institution-experience
#5
Katherine Habenicht Yancey, Lauren Katherine McCormack, Stephen Samuel McNatt, Myron Sheavictor Powell, Adolfo Zachariah Fernandez, Carl Joseph Westcott
Background: Laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP) is used for treatment in patients after Roux-en-Y gastric bypass (RYGB), where transoral access to the biliary tree is not possible. We describe our technique and experience with this procedure. Methods: Electronic medical record search was performed from September 2012 to January 2016, identifying patients who underwent LAERCP per operative records. Charts were reviewed for demographic, clinical, and outcomes data...
2018: Journal of Obesity
https://www.readbyqxmd.com/read/29754385/four-year-evolution-of-a-thrombophylaxis-protocol-in-an-enhanced-recovery-after-surgery-eras-program-recent-results-in-485-patients
#6
Marie-Cécile Blanchet, Vincent Frering, Benoît Gignoux, Yann Matussière, Philippe Oudar, Romain Noël, Alban Mirabaud
"Enhanced recovery after surgery" (ERAS) protocols may reduce morbidity, length of hospital stay (LOS), and costs. During the 4-year evolution of a bariatric ERAS protocol, we found that administration of thrombophylaxis selectively to high-risk morbidly obese patients (assessed postoperatively by Caprini score ≥ 3) undergoing omega loop gastric bypass ("mini" gastric bypass) or sleeve gastrectomy resulted in safe outcomes. Both procedures proved equally effective with this protocol...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29748126/feeding-the-gut-after-revisional-bariatric-surgery-the-fate-of-126-enteral-access-tubes
#7
Andrew T Strong, Hana Fayazzadeh, Gautam Sharma, Kevin El-Hayek, Matthew Kroh, John Rodriguez
BACKGROUND: Revisional bariatric surgery (RBS) is associated with higher complication rates compared with primary bariatric surgery. Feeding tubes (FTs), including gastrostomy and jejunostomy tubes placed during RBS, may serve as a safety net to provide nutrition when oral intake is contraindicated or limited; however, FTs in this setting have not been well investigated. OBJECTIVES: This study aims to determine complications, use, and duration of FTs placed during RBS...
March 9, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29739229/efficacy-and-safety-of-transoral-outlet-reduction-via-endoscopic-suturing-in-patients-with-weight-regain-after-a-surgical-roux-en-y-gastric-bypass
#8
Eduardo Espinet Coll, Javier Nebreda Durán, Gontrand López-Nava Breviere, Manoel Galvao Neto, José Antonio Gómez Valero, Silvia Bacchiddu, Carmen Vila Lolo, Patricia Díaz Galán, Inmaculada Bautista-Castaño, Antonio Juan-Creix Comamala
INTRODUCTION: many patients that undergo bariatric surgery (Roux-en-Y gastric bypass [RYGB]) may regain some of their weight lost over time. A transoral outlet reduction (TORe) with endoscopic suture could be a valid alternative in these patients. METHODS: this was a retrospective initial series of 13 consecutive patients with weight regain after RYGB and a dilated gastro-jejunal anastomosis (> 15 mm). TORe was performed using an endoscopic transmural suture device (OverStitch-Apollo®), which was used to reduce the anastomosis aperture and also to treat the gastric pouch...
May 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29735346/severe-anemia-after-roux-en-y-gastric-bypass-a-cause-for-concern
#9
Emily McCracken, G Craig Wood, Wesley Prichard, Bruce Bistrian, Christopher Still, Glenn Gerhard, David Rolston, Peter Benotti
BACKGROUND: The current popularity of metabolic surgery has led to increasing attention to long-term nutritional complications. OBJECTIVE: The purpose of this retrospective study is to accurately define the long-term incidence of clinically significant anemia after Roux-en-Y gastric bypass (RYGB) and to identify factors that contribute to increased risk. METHODS: The study cohort consisted of 2116 patients who underwent RYGB with necessary laboratory information available, and with longitudinal follow-up available (mean 5...
March 28, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29732709/restoration-of-enteroendocrine-and-pancreatic-function-after-internal-hernia-and-short-bowel-syndrome-in-a-young-woman-with-gastric-bypass-a-2-year-follow-up
#10
Märta Borghede, Lars Vinter-Jensen, Henrik H Rasmussen, Simon Veedfald, Jens F Rehfeld, Bolette Hartmann, Jens J Holst, Filip K Knop, David P Sonne
A serious complication to the laparoscopic Roux-en-Y gastric bypass (RYGB) is internal hernia, which can lead to massive bowel necrosis that may result in short bowel syndrome. We determined postprandial enteropancreatic hormonal responses and metabolites in a 22-year-old nondiabetic woman with a history of RYGB experiencing severe internal herniation with widespread bowel necrosis. Extensive resections were performed leaving her with a saliva fistula from the pouch-enteric anastomosis, an intact duodenum, 15 cm of jejunum, 35 cm of ileum, and intact colon...
May 2018: Physiological Reports
https://www.readbyqxmd.com/read/29730162/the-readmission-contradiction-toward-clarifying-common-misconceptions-about-bariatric-readmissions-and-quality-improvement
#11
Anthony Petrick, Shannon A Brindle, Ellen Vogels, James Dove, David Parker, Jon Gabrielsen
BACKGROUND: Efforts to improve quality in U.S. medicine have included reimbursement penalties for readmissions. OBJECTIVES: This study's first phase measured readmissions after initial bariatric surgery and analyzed surgical outcomes secondarily. The second phase aimed to identify nonclinical factors associated with bariatric readmissions. SETTING: Rural U.S. academic hospital. METHODS: This retrospective study analyzed a prospective database of patients undergoing initial Roux-en-Y gastric bypass or sleeve gastrectomy between May 1, 2007 and April 30, 2015...
February 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29725975/probiotic-supplementation-in-morbid-obese-patients-undergoing-one-anastomosis-gastric-bypass-mini-gastric-bypass-oagb-mgb-surgery-a-randomized-double-blind-placebo-controlled-clinical-trial
#12
Zohreh Karbaschian, Zeinab Mokhtari, Abdolreza Pazouki, Ali Kabir, Mahdi Hedayati, Somayeh Soleymanzadeh Moghadam, Parvin Mirmiran, Azita Hekmatdoost
BACKGROUND: Bariatric surgery is known as one of the most effective treatments for sustainable weight loss; however, it may be associated with some complications. This study was designed to examine the effects of probiotic supplementation on some morbidities related to this surgery. METHODS: This was a placebo-controlled, double-blind, randomized clinical trial on morbid obese patients referred for One Anastomosis Gastric Bypass- Mini Gastric Bypass (OAGB-MGB) surgery to a tertiary referral center...
May 3, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29724681/incidence-of-cholecystectomy-after-bariatric-surgery
#13
Maria S Altieri, Jie Yang, Lizhou Nie, Salvatore Docimo, Mark Talamini, Aurora D Pryor
BACKGROUND: Bariatric surgery predisposes patients to development of cholelithiasis, and therefore the need of a subsequent cholecystectomy; however, the incidence of cholecystectomy after bariatric surgery is debated. OBJECTIVE: The purpose of our study is to assess the incidence of cholecystectomy after 3 of the most common bariatric procedures. SETTING: University Hospital, involving a large database in New York State. METHODS: The Statewide Planning and Research Cooperative System administrative longitudinal database was used to identify all patients undergoing Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2004 and 2010...
March 30, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29724616/a-landscape-of-bariatric-surgery-in-canada-for-the-treatment-of-obesity-type-2-diabetes-and-other-comorbidities-in-adults
#14
REVIEW
Mehran Anvari, Rodrigo Lemus, Ruth Breau
Obesity has escalated worldwide and in Canada. Many chronic conditions, including type 2 diabetes, are directly correlated with obesity, and although the benefits and effectiveness of bariatric surgery have been proven in terms of sustained weight loss and improving comorbidities, the procedure is underaccessed and underutilized in Canada. We explored the complex landscape of bariatric surgery in Canada, reviewing the current state and focusing on the volume of procedures nationwide and at the provincial level, the type of surgical procedures performed, their outcomes and their associated complications...
December 12, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29722910/glycemic-management-in-the-bariatric-surgery-population-a-review-of-the-literature
#15
Meredith L Howard, Taylor D Steuber, Sarah A Nisly
Obesity is a worldwide epidemic often complicated by multiple comorbidities, including type 2 diabetes mellitus (T2DM). Bariatric surgery is an increasingly common and effective weight loss strategy for obese patients that may result in resolution of metabolic related disease states, such as T2DM. Although bariatric surgery has many positive outcomes for patients, dietary and pathophysiologic changes can create difficult to control blood glucose, especially in the immediate perioperative setting. Depending on oral antidiabetic agent and insulin needs preoperatively, many patients require cessation of oral agents and reduction or cessation of insulin...
May 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29721620/multiple-vertebral-fractures-sustained-5-months-after-roux-en-y-gastric-bypass-a-case-report
#16
Susie C Higgins, George Papasavvas
INTRODUCTION: We report a case of a patient sustaining multiple simultaneous vertebral fractures 5 months after Roux-en-Y gastric bypass (RYGB) surgery. Obesity is associated with increased rates of morbidity and mortality and obesity rates globally continue to rise. Bariatric surgical procedures are successful in inducing sustained weight loss with many improved health outcomes. Potential complications include nutritional deficiencies and adverse effects on bone mineral metabolism with increased rates of fracture...
May 2, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29716802/perforated-duodenal-ulcers-after-roux-y-gastric-bypass
#17
Denise Pohl, Gregoire Schmutz, Gabriel Plitzko, Dino Kröll, Philipp Nett, Yves Borbély
Even though the incidence of complicated peptic ulcer disease (PUD) has decreased in the last decades, it remains a condition with a significant mortality. Whilst diagnosis and treatment of PUD in morbidly obese patients can be challenging, patients with excluded segments - such as after Roux-Y Gastric Bypass (RYGB) - present an even greater problem, as the subsequent altered anatomy impedes the common modalities used for diagnostic and therapeutic measures. We report the cases of two patients after RYGB with perforated duodenal ulcers in the intention to highlight problems regarding diagnosis and treatment...
April 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29713829/bariatric-surgery-increases-risk-of-bone-fracture
#18
Anna Z Fashandi, J Hunter Mehaffey, Robert B Hawkins, Bruce Schirmer, Peter T Hallowell
INTRODUCTION: The purpose of this study was to determine the long-term incidence of bone fracture after bariatric surgery, identify specific risk factors for fracture, and compare these data to baseline risk in a comorbidity-matched morbidly obese population. We hypothesize that, despite prior studies with conflicting results, bariatric surgery increases a patient's long-term risk of fracture. METHODS: All patients who underwent bariatric surgery at a single institution 1985-2015 were reviewed...
April 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29704739/silastic-band-erosion-in-the-bypassed-stomach-after-fobi-pouch-operation-for-obesity-case-report
#19
A M Franco-Martínez, M Guraieb-Trueba, R Castañeda-Sepúlveda, E A Flores-Villalba, J Rojas-Méndez
INTRODUCTION: Worldwide, one of the most commonly performed bariatric surgeries is the laparoscopic Roux-en-Y gastric bypass (LRYGP). Access to the bypassed stomach in patients who have undergone this procedure, for evaluation and/or management in different clinical situations remains a challenge for the physician. In order to facilitate the entrance to the gastric remnant, a silastic marker is left in place during the Fobi-Pouch operation, a modified laparoscopic gastric bypass surgery technique...
March 15, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29703503/fasting-levels-of-glicentin-are-higher-in-roux-en-y-gastric-bypass-patients-exhibiting-postprandial-hypoglycemia-during-a-meal-test
#20
Christine Poitou, Elodie Bouaziz-Amar, Laurent Genser, Jean-Michel Oppert, Jean-Marc Lacorte, Johanne Le Beyec
BACKGROUND: Post-bypass postprandial hypoglycemia (PPH) is a frequent complication of Roux-en-Y Gastric Bypass (RYGB) but predictors remain poorly identified and are needed to assess individual risk. After RYGB, exaggerated secretion of glucagon-like peptide-1 (GLP-1) and insulin could lead to PPH, but other proglucagon-derived peptides, including glicentin and glucagon, could also contribute to this phenomenon. OBJECTIVES: To identify biological hypoglycemia in relation to the secretion of proglucagon-derived peptides during a mixed-meal test (MMT) in RYGB patients...
March 19, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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