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Gastric sleeve complications

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https://www.readbyqxmd.com/read/28730276/effect-of-patient-reported-smoking-status-on-short-term-bariatric-surgery-outcomes
#1
Michael Inadomi, Rahul Iyengar, Ilana Fischer, Xing Chen, Emily Flagler, Amir A Ghaferi
INTRODUCTION: Preoperative patient screening is a major contributor to the remarkable safety of bariatric surgery. Smoking status is a modifiable patient risk factor, and smoking cessation is associated with improved outcomes in surgical patients. However, the length of smoking cessation necessary to optimize bariatric surgery patient outcomes is not yet defined. We sought to explore the relationship between patient-reported smoking status and short-term bariatric surgery outcomes. METHODS: Using prospectively collected data from the MBSC registry, we evaluated the effects of patient-reported length of tobacco abstinence on 30-day surgical outcomes...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28728833/unexplained-abdominal-pain-in-morbidly-obese-patients-after-bariatric-surgery
#2
Annouk S Pierik, Usha K Coblijn, Christel A L de Raaff, R N van Veen, Willem F van Tets, Bart A van Wagensveld
BACKGROUND: There is an overall complication rate of 6.3%-10% after bariatric surgery. After ruling out anatomic/physical causes, there is a substantial group of patients who develop unexplained postsurgical abdominal pain. OBJECTIVES: To inventory the prevalence of unexplained abdominal pain after laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and to determine predictive factors for unexplained abdominal pain. SETTING: Obesity Center Amsterdam, Amsterdam, the Netherlands...
July 3, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#3
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#4
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#5
Hany Shehab, Emad Abdallah, Khaled Gawdat, Inas Elattar
BACKGROUND: Endoscopic stents are successful in the management of surgical leaks; however, stent migration remains a significant problem. In this study, we present our approach depending on a large bariatrics-specific stent (Mega stent) and over-the-scope clips in the management of post-bariatric surgery leaks. METHODS: A retrospective analysis of all patients with post-bariatric surgery leaks treated at our institution using an approach reliant on Mega stents and over-the-scope clips was conducted...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695879/iatrogenic-injury-of-the-intrathoracic-oesophagus-with-bougie-during-sleeve-gastrectomy
#6
Franco José Signorini, Gorodner Verónica, Marani Marcos, Viscido German, Moser Federico
One of the most popular procedures amongst obesity surgery is the sleeve gastrectomy. There is international consensus regarding the usage of bougie for sleeve gastrectomy calibration. Nevertheless, there is a dissociation between the number of oesophageal perforations reported for any other oesophageal/gastric operation that requires bougie (e.g., anti-reflux surgery, incidence 1.2%) and bariatric surgery, where this complication seems to be almost a myth. Interestingly enough, the number of bariatric procedures is much higher than any other oesophageal/gastric surgery...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28695459/endoscopic-vacuum-therapy-evt-a-new-concept-for-complication-management-in-bariatric-surgery
#7
Fabian Schmidt, Rudolf Mennigen, Thorsten Vowinkel, Philipp A Neumann, Norbert Senninger, Daniel Palmes, Mike G Laukoetter
BACKGROUND: Bariatric surgery is the most efficient therapy for morbid obesity. Staple line and anastomotic leakage are the most feared postoperative complications after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (LSG). Traditional treatment options like revisional surgery and endoscopic stent placement are associated with high morbidity and mortality as well as variable success rates. Endoscopic vacuum therapy (EVT) has shown to be a new successful and feasible treatment option for leaks of different etiology after major gastro-esophageal surgery...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28681327/bariatric-surgery-for-adolescents-with-type-2-diabetes-an-emerging-therapeutic-strategy
#8
REVIEW
M A Stefater, T H Inge
PURPOSE OF REVIEW: Type 2 diabetes (T2D) is a growing public health problem in youth, but conventional treatments are often insufficient to treat this disease and its comorbidities. We review evidence supporting an emerging role for bariatric surgery as a treatment for adolescent T2D. RECENT FINDINGS: Paralleling what has been seen in adult patients, bariatric surgery dramatically improves glycemic control in patients with T2D. In fact, remission of T2D has been observed in as many as 95-100% of adolescents with diabetes after bariatric surgery, particularly vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28681283/the-visualization-of-gastro-esophageal-junction-vascular-supply-during-a-laparoscopic-sleeve-gastrectomy-role-of-a-new-device
#9
Mario Musella, Marco Milone, Paolo Bianco, Francesco Milone
Leaks arising at the level of gastro-esophageal junction remain a major complication in patients who undergo a laparoscopic sleeve gastrectomy. Besides technical pitfalls, these fistulas are mainly attributable to tissue ischemia following the preparation of the gastric sleeve, explained by the irregular vascularization often present in the area of the gastro-esophageal junction. This video presentation shows how, the utilization of a new model of bougie can be of help in preventing a leak, allowing a better visualization of the particular vascular anatomy present at the level of the gastro-esophageal junction area...
July 5, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28668407/current-and-cutting-edge-interventions-for-the-treatment-of-obese-patients
#10
REVIEW
Jenanan Vairavamurthy, Lawrence J Cheskin, Dara L Kraitchman, Aravind Arepally, Clifford R Weiss
The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current "gold standard" therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28647931/correct-evaluation-of-gastric-wall-thickness-may-support-a-change-in-staplers-size-when-performing-sleeve-gastrectomy
#11
Sergio Susmallian, David Goitein, Royi Barnea, Asnat Raziel
BACKGROUND: Leakage from the staple line is the most serious complication encountered after sleeve gastrectomy, occurring in 2.4% of surgeries. The use of inappropriately sized staplers, because of variability in stomach wall thickness, is a major cause of leakage. OBJECTIVES: To measure stomach wall thickness across different stomach zones to identify variables correlating with thickness. METHODS: The study comprised 100 patients (52 females)...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28647410/reoperative-bariatric-surgery-for-treatment-of-type-2-diabetes-mellitus
#12
Jingliang Yan, Ricardo Cohen, Ali Aminian
Primary bariatric surgery has been proven to be effective in weight loss and improvement of weight-related metabolic co-morbidities. However, a small proportion of patients after bariatric surgery either have persistent hyperglycemia or relapse after initial remission of their metabolic disease. Revisional bariatric surgery has been evaluated extensively for weight recidivism and postoperative complications. However, there has not been any high-level evidence validating the utility of revisional bariatric surgery on recurrent metabolic diseases, especially diabetes...
April 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28623446/laparoscopic-sleeve-gastrectomy-investigation-of-fundus-wall-thickness-and-staple-height-an-observational-cohort-study-fundus-wall-thickness-and-leaks
#13
Clara Boeker, Julian Mall, Christian Reetz, Kamil Yamac, Ludwig Wilkens, Christine Stroh, Hinrich Koehler
BACKGROUND: Staple line leakage is a well-known complication after laparoscopic sleeve gastrectomy (LSG). Gastric wall thickness and the staple height may be determining factors for the occurrence of insufficiencies. To investigate this problem, an observational cohort study was carried out. Investigation concentrated on the gastroesophageal junction close to the angle of His, since this area is at highest risk for a leakage. METHODS: Fundus wall thickness of 141 specimens after LSG was measured by light microscopy at a predetermined location by a blinded pathologist...
June 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28607328/endoscopic-sleeve-gastroplasty-a-new-tool-to-manage-obesity
#14
Deepanshu Jain, Bharat Singh Bhandari, Ankit Arora, Shashideep Singhal
Obesity is a growing pandemic across the world. Dietary restrictions and behavior modifications alone have a limited benefit. Bariatric surgery, despite being the current gold standard, has limited acceptance by patients due to cost and associated morbidity. In our review, we have discussed nine original studies describing endoscopic sleeve gastroplasty (ESG). A total of 172 subjects successfully underwent ESG. Of 65 subjects with follow up data, 95.4% (62/65) had intact gastric sleeve confirmed via esophagogastroduodenoscopy or oral contrast study at the end of study specific follow up interval (the longest being 6 months)...
June 13, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28602794/long-term-outcome-of-laparoscopic-adjustable-gastric-banding-lagb-results-of-a-swiss-single-center-study-of-405-patients-with-up-to-18-years-follow-up
#15
Fabrizio Vinzens, Ashley Kilchenmann, Valentin Zumstein, Marc Slawik, Martina Gebhart, Ralph Peterli
BACKGROUND: In the past, laparoscopic adjustable gastric banding (LAGB) seemed to be a promising bariatric procedure. However, many studies showed high rates of reoperation due to complications or insufficient weight loss. There is a lack of long-term studies with follow-up beyond 15 years. OBJECTIVE: To conduct long-term follow-up of patients after LAGB and analyze their weight loss as a primary endpoint. SETTING: Tertiary referral center for bariatric surgery, St...
April 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28601866/cost-utility-analysis-of-bariatric-surgery-in-italy-results-of-decision-analytic-modelling
#16
Marcello Lucchese, Oleg Borisenko, Lorenzo Giovanni Mantovani, Paolo Angelo Cortesi, Giancarlo Cesana, Daniel Adam, Elisabeth Burdukova, Vasily Lukyanov, Nicola Di Lorenzo
OBJECTIVE: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. METHODS: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature...
2017: Obesity Facts
https://www.readbyqxmd.com/read/28600616/utilization-of-body-contouring-procedures-following-weight-loss-surgery-a-study-of-37-806-patients
#17
Maria S Altieri, Jie Yang, Jihye Park, David Novikov, Lijuan Kang, Konstantinos Spaniolas, Andrew Bates, Mark Talamini, Aurora Pryor
BACKGROUND: Bariatric surgery has substantial health benefits; however, some patients desire body contouring (BC) procedures following rapid weight loss. There is a paucity of data regarding the true rate of BC following bariatric procedures. The purpose of our study is to examine the utilization of two common procedures, abdominoplasty, and panniculectomy, following bariatric surgery in New York State. METHODS: The SPARCS longitudinal administrative database was used to identify bariatric procedures by using ICD-9 and CPT codes between 2004 and 2010...
June 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28593482/diagnostic-performance-of-c-reactive-protein-in-detecting-post-operative-infectious-complications-after-laparoscopic-sleeve-gastrectomy
#18
Fadia Dib, Lara Ribeiro Parenti, Anne Boutten, David Hajage, Jean-Pierre Marmuse
BACKGROUND: Gastric leak is the most common and dreaded post-operative infectious complication (PIC) after laparoscopic sleeve gastrectomy (LSG). Accurate identification of patients at risk postoperatively is of cardinal importance. OBJECTIVE: The aim of this study is to assess the diagnostic performance of C-reactive protein (CRP) in predicting PICs and the most optimal time to measure it. METHODS: CRP results were collected in patients undergoing LSG between 2011 and 2015...
June 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28569358/revision-procedures-after-failed-adjustable-gastric-banding-comparison-of-efficacy-and-safety
#19
Pawan Chansaenroj, Lwin Aung, Wei-Jei Lee, Shu Chun Chen, Jung-Chien Chen, Kong-Han Ser
BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) was one of the commonly performed bariatric operations; however, it carries a high revision rate. The aim of the present study was to report the long-term outcomes of LAGB and compare the outcomes between the different revision procedures. METHODS: All patients who underwent LAGB in a large bariatric center in Asia between May 2002 and April 2011 were included. Interval between primary LAGB to the revision operation, the reason and type of revision surgery were identified and analyzed...
May 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28569357/complications-following-the-mini-one-anastomosis-gastric-bypass-mgb-oagb-a-multi-institutional-survey-on-2678-patients-with-a-mid-term-5%C3%A2-years-follow-up
#20
Mario Musella, Antonio Susa, Emilio Manno, Maurizio De Luca, Francesco Greco, Marco Raffaelli, Stefano Cristiano, Marco Milone, Paolo Bianco, Antonio Vilardi, Ivana Damiano, Gianni Segato, Laura Pedretti, Piero Giustacchini, Domenico Fico, Gastone Veroux, Luigi Piazza
BACKGROUND: In recent years, several articles have reported considerable results with the Mini/One Anastomosis Gastric Bypass (MGB/OAGB) in terms of both weight loss and resolution of comorbidities. Despite those positive reports, some controversies still limit the widespread acceptance of this procedure. Therefore, a multicenter retrospective study, with the aim to investigate complications following this procedure, has been designed. PATIENTS AND METHODS: To report the complications rate following the MGB/OAGB and their management, and to assess the role of this approach in determining eventual complications related especially to the loop reconstruction, in the early and late postoperative periods, the clinical records of 2678 patients who underwent MGB/OAGB between 2006 and 2015 have been studied...
May 31, 2017: Obesity Surgery
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