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Gastric bypass BMI limits

Murray R Williams, Samuel McMeekin, R Jonathan T Wilson, Glenn V Miller, Fiona E Langlands, Wingzou Wong, Mark Peter, Mathew S Giles
BACKGROUND: Laparoscopic roux-en-Y gastric bypass (LRYGB) has gained increasing popularity as the primary procedure of choice for the management of patients with morbid obesity. Despite the advances, a few patients will still develop complications and predicting these early complications in morbidly obese patients can prove to be difficult. Radiological investigations have limited diagnostic value and have associated side effects and cost. We propose that C-reactive protein (CRP) is a useful predictor for early postoperative complications...
September 29, 2016: Obesity Surgery
George Tharakan, Rebecca Scott, Olivia Szepietowski, Alexander D Miras, Alexandra I Blakemore, Sanjay Purkayastha, Ahmed Ahmed, Harvinder Chahal, Tricia Tan
PURPOSE: This study aimed to determine the predictive power of the DiaRem score following Roux-en-Y gastric bypass to identify patients who would have diabetes remission at 1 year in an ethnically diverse population. METHODS: We performed a retrospective review of 262 patients with type 2 diabetes mellitus who underwent RYGB at the Imperial Weight Centre, UK, from 2007 to 2014. Data was collected on the parameters required to calculate the DiaRem score as well as pre- and post-surgical weight and the ethnicity of the subjects...
September 10, 2016: Obesity Surgery
B Stratmann, Y Krepak, E Schiffer, I Jarick, M Hauber, Y H Lee-Barkey, M Fischer, D Tschoepe
Implantation of a duodenal-jejunal endoluminal bypass liner (DJBL) has shown to induce weight loss and to improve metabolic parameters. DJBL is a reversible endoduodenal sleeve mimicking duodenal bypass while lacking risks and limitations of bariatric surgery.Effects on metabolic control, body mass parameters, appetite regulation, glucose tolerance, organ health, and lipid profile were determined in 16 morbidly overweight patients with type 2 diabetes mellitus. In addition, relevant hormones (leptin, ghrelin, gastric inhibitory peptide, glucagon-like peptide, and insulin) were measured by enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) at 0, 1, 32, and 52 weeks post-implant following a mixed meal tolerance test...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Fabio Garofalo, Ronald Denis, Radu Pescarus, Henri Atlas, Simon L Bacon, Pierre Garneau
BACKGROUND: Bariatric surgery has been proven to be a safe and effective treatment for obesity with BMI (body mass index) reduction, and resolution or lowering of obesity-related co-morbidities. The relative age limit for bariatric surgery has gradually been increased to 60 years of age and above. OBJECTIVES: The aim of this study was to assess the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) performed in older patients (≥65 years old). SETTING: University hospital...
May 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Fateme Arabi Basharic, Alireza Olyaee Manesh, Mohammad Ranjbar Ezzat Abadi, Seyed Mostafa Shiryazdi, Hussein Shabahang, Ali Jangjoo
BACKGROUND: Prevalence of obesity in the world, in both developed and developing countries, is growing rapidly. Bariatric surgery is now accepted as the treatment for morbid obesity. OBJECTIVE: This study compares laparoscopic sleeve gastrectomy's effectiveness (LSG) with the most common bariatric surgery, laparoscopic Roux-en-Y (LRYGB) gastric bypass. METHODS: A systematic review was performed using relevant search data bases, including Cochrane library, PubMed, Magi ran, Iranmedex, SID and Trip database, with no time limit...
2016: Medical Journal of the Islamic Republic of Iran
Adam C Celio, Kevin R Kasten, Matthew B Burruss, Walter J Pories, Konstantinos Spaniolas
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a commonly performed bariatric procedure. Readmissions are used as a quality indicator with a nationwide emphasis on reduction. In LRYGB surgery, surgeon volume studies have focused on correlation with technical outcomes, offering limited data on readmissions. Our aim was to evaluate nationwide data to explore the relationship between surgeon case volume and hospital readmissions following LRYGB. METHODS: The Bariatric Outcomes Longitudinal Database from 2011 was used for this study...
July 21, 2016: Surgical Endoscopy
Ekua Yorke, Noah Jacob Switzer, Artan Reso, Xinhe Shi, Christopher de Gara, Daniel Birch, Richdeep Gill, Shahzeer Karmali
Older models of intragastric balloons (IGBs) had unacceptably high complication rates and inconsequential weight loss. With FDA approval of newer models, we aimed to systematically examine the literature regarding the efficacy of IGB therapy for obesity. A comprehensive electronic database search was completed. Title searching was restricted to the following keywords: bariatric, gastric, gastric bypass, gastric band, sleeve gastrectomy, and intragastric balloon. Twenty-six primary studies (n = 6101) were included...
September 2016: Obesity Surgery
Martine Uittenbogaart, Wouter Kg Leclercq, Arijan Apm Luijten, Francois Mh van Dielen
BACKGROUND: Roux-en-Y gastric bypass (RYGB) is associated with approximately 25 % weight loss failure, resulting in insufficient weight loss or weight regain. Strategies of revisional surgery focus on alteration of limb length, pouch or stoma size. Altering pouch size and outlet by adding laparoscopic adjustable gastric band (LAGB) might initiate further weight loss. The goal of this study is to review the safety and efficacy of LAGB after failed RYGB in a retrospective cohort of patients in our institute...
July 13, 2016: Obesity Surgery
Jenny H Lee, Quynh-Nhu Nguyen, Quang A Le
BACKGROUND: Bariatric surgery is associated with improved co-morbidities, quality of life, and survival in severely obese patients. Common bariatric surgery procedures include Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric band (LAGB), and sleeve gastrectomy (SG). Currently, literature studying comparative effectiveness on different bariatric surgery procedures in veterans is limited. OBJECTIVES: To compare effectiveness of 3 bariatric surgery procedures performed in veterans...
June 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Sahar Fallahi-Shahabad, Mohsen Mazidi, Alireza Tavasoli, Peyman Rezaie, Fatemeh Rohani, Simindokht Habibzadeh, Emadodin Darchini-Maragheh, Zohreh Sadat Sang Sefidi, Mohammad Safarian, Majid Ghayour Mobarhan, Mohammad Taghi Rajabi, Abdolreza Norouzy, Seyed Mohammad Reza Parizadeh, Saeid Akhlaghi, Shima Tavalaie, Fatemeh Firouzi, Mohsen Nematy
BACKGROUND AND AIM: Obesity is one of the greatest public health concerns worldwide. Weight loss surgeries have been increased in recent decades due to the world's epidemic of obesity. The aim of this prospective study is investigating metabolic factors of morbid obese patients following Roux-en-Y gastric bypass surgery. METHODS: This was a nonrandomized prospective cohort study conducted from 2010 to 2013 on 60 consecutive patients who had body mass index (BMI) of more than 40 kg/m(2) and met the surgical indication criteria of bariatric surgery...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Mena Boules, Ricard Corcelles, Andrea Zelisko, Esam Batayyah, Dvir Froylich, John Rodriguez, Stacy Brethauer, Kevin El-Hayek, Matthew Kroh
BACKGROUND: Obesity is an epidemic on the rise. Increasing body mass index (BMI) has been associated with a number of comorbid diseases, including rarely reported motility disorders such as achalasia. Motility disorders are prevalent in obese patients, possibly more prevalent when compared to the nonobese population. Identification of motility disorders is important before bariatric surgery and may alter the planned type of procedure performed. Limited data exist regarding the development or existence of esophageal motility disorders after bariatric surgery...
June 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hella Scotland, Jeannette D Widmer, Stefan Wildi, Marco Bueter, Markus Weber, Markus K Muller
OBJECTIVE: Despite following international guidelines and conducting routine preoperative dietary counseling, every bariatric surgeon will encounter technical challenges in laparoscopic gastric bypass surgery. We present a series of patients in whom the bariatric procedure was stopped after encountering insufficient exposure during diagnostic laparoscopy. These patients were sent back for dietary counseling and underwent surgery after conservative weight loss. The data from this two-step procedure are analyzed and discussed...
May 2016: Langenbeck's Archives of Surgery
Rena C Moon, Lars Nelson, Andre F Teixeira, Muhammad A Jawad
BACKGROUND: Reports on the outcomes of Roux-en-Y gastric bypass (RYGB) in super-obese patients are limited, especially on patients with body mass index (BMI)≥60 kg/m(2). OBJECTIVES: The aim of the present study was to evaluate and compare the tolerability and efficacy of RYGB in the super-obese by comparing patients with a BMI of 50-60 kg/m(2) and a BMI of≥60 kg/m(2) with patients with a BMI of 40-50 kg/m(2). SETTING: Academic practice...
February 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Rocco Barazzoni, Silvia Palmisano, Gianluca Gortan Cappellari, Michela Giuricin, Elisa Moretti, Pierandrea Vinci, Annamaria Semolic, Gianfranco Guarnieri, Michela Zanetti, Nicolò de Manzini
BACKGROUND: Systemic inflammation contributes to obesity-associated complications. The short pentraxin C-reactive protein (CRP) is a validated inflammatory marker, whereas long pentraxin-3 (PTX3) limits inflammation and is adaptively stimulated by proinflammatory cytokines in vitro. Severely obese (SO) patients (body mass index [BMI]>40] have the highest obesity-associated complications and increasingly undergo surgical treatment. SO-associated changes in plasma PTX3 and their interactions with systemic inflammation are, however, unknown...
January 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Lars Nelson, Rena C Moon, Andre F Teixeira, Muhammad A Jawad
BACKGROUND: Postoperative leaks from the staple lines are a serious complication after laparoscopic Roux-en-Y gastric bypass (RYGB) that results in morbidity and could even lead to mortality. Bariatric surgeons have several tools to assess this adversity. There have been debates as to which method is more superior and furthermore whether these methods should be routinely or selectively used. The aim of our study is to evaluate and compare whether methylene blue or upper gastrointestinal (UGI) study is more effective in detecting an anastomotic leak after RYGB...
October 2015: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Anna Dayer-Jankechova, Pierre Fournier, Pierre Allemann, Michel Suter
BACKGROUND: Roux-en-Y gastric bypass (RYGBP), one of the commonest performed bariatric procedures, remains a technically challenging operation associated with significant morbidity in high-risk patients. This study was conducted in order to identify predictors of complications after laparoscopic RYGBP. METHODS: Our prospectively established database has been assessed to review 30-day and in-hospital complications graded according to a validated scoring system (Clavien-Dindo) and separated into minor (Clavien-Dindo I-IIIa) and major (Clavien-Dindo IIIb-IV) complications...
January 2016: Obesity Surgery
Robert A Li, David P Fisher, Sanjoy Dutta, Rebecca M O'Brien, Lynn M Ackerson, Michael E Sorel, Stephen Sidney
BACKGROUND: Limited data have been reported on bariatric surgery within a large, high-volume regional multicenter integrated healthcare delivery system. OBJECTIVES: Review clinical characteristics and short- and intermediate-term outcomes and adverse events from a bariatric surgery program within an integrated healthcare delivery system. SETTING: Single high-volume, multicenter regional integrated healthcare delivery system. METHODS: Adult patients who underwent primary bariatric surgery during 2010-2011 were reviewed...
September 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
J Hunter Mehaffey, Damien J LaPar, Florence E Turrentine, Michael S Miller, Peter T Hallowell, Bruce D Schirmer
BACKGROUND: There is limited outcome data for super-super-obese (SSO) patients, those with Body Mass Index (BMI) ≥ 60 kg/m(2), who seek surgical treatment with Laparoscopic Roux-en-Y Gastric Bypass (LRYGB). A large single center LRYGB experience was reviewed to compare the safety and efficacy of LRYGB in SSO patients to the standard obese population undergoing this procedure. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database and an Institutional Review Board approved prospective database was used to identify all patients undergoing LRYGB by multiple surgeons at a single institution between 1/1/1994 and 11/15/2013...
July 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Sarit Polsky, William T Donahoo, Ella E Lyons, Kristine L Funk, Thomas E Elliott, Rebecca Williams, David Arterburn, Jennifer D Portz, Elizabeth Bayliss
OBJECTIVES: To examine the effect of pre- and postoperative care management on weight loss following bariatric surgery. STUDY DESIGN: We conducted a retrospective cohort study supplemented by cross-sectional surveys across 9 bariatric surgery centers. METHODS: Based on the intensity of patient contact, care management intensity (CMI) was defined as high, moderate, or low for preoperative programs, and high or low for postoperative programs...
March 2015: American Journal of Managed Care
Anita P Courcoulas, Nicholas J Christian, Robert W O'Rourke, Greg Dakin, E Patchen Dellinger, David R Flum, Ph D Melissa Kalarchian, James E Mitchell, Emma Patterson, Alfons Pomp, Walter J Pories, Konstantinos Spaniolas, Kristine Steffen, Bruce M Wolfe, Steven H Belle
BACKGROUND: Limited data guide the prediction of weight loss success or failure after bariatric surgery according to presurgery factors. There is significant variation in weight change after bariatric surgery and much interest in identifying preoperative factors that may contribute to these differences. This report evaluates the associations of a comprehensive set of baseline factors and 3-year weight change. SETTING: Ten hospitals in 6 geographically diverse clinical centers in the United States...
September 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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