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Laparoscopic gastric bypass

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
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
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
Rinki Murphy, Peter Tsai, Mia Jüllig, Amy Liu, Lindsay Plank, Michael Booth
BACKGROUND: It is unclear whether specific gut microbiota is associated with remission of type 2 diabetes (T2D) after distinct types of bariatric surgery. AIMS: The aim of this study is to examine gut microbiota changes after laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery in obese patients with T2D. METHODS: Whole-metagenome shotgun sequencing of DNA fragments using Illumina HiSeq2000 was obtained from stool samples collected from 14 obese T2D patients pre-operatively (while on very low calorie diet) and 1 year after randomisation to laparoscopic SG (n = 7) or RYGB (n = 7)...
October 13, 2016: Obesity Surgery
Siva T Gounder, Delendra Rasith Wijayanayaka, Rinki Murphy, Delwyn Armstrong, Richard G Cutfield, David Dw Kim, Michael Graham Clarke, Nicholas J Evennett, Martyn Lee Humphreys, Steven John Robinson, Michael Wc Booth
AIM: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. METHODS: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery...
October 14, 2016: New Zealand Medical Journal
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
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
Xiao Du, Hong-Xu Zhou, Si-Qin Zhang, Hao-Ming Tian, Zong-Guang Zhou, Zhong Cheng
BACKGROUND: The metabolic effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes (T2D) patients who do not meet National Institutes of Health indications has not been well studied. OBJECTIVES: To compare the effectiveness of LSG and LRYGB in Chinese T2D patients with body mass index (BMI)<35 kg/m(2). SETTING: University hospital, China. METHODS: A nonrandomized cohort of patients who underwent LRYGB (n = 64) and LSG (n = 19) were followed up for 3 years and the outcomes (weight loss and remission of diabetes and other metabolic parameters) were compared...
August 31, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Saeed Shoar, Alan A Saber
OBJECTIVE: This study aimed to compare midterm and long-term weight loss and resolution of co-morbidity with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). SUMMARY: LRYGB and LSG are the most common procedures performed in bariatric surgery. However, their weight loss efficacy in the midterm and long-term has not been well compared. METHODS: A meta-analysis was performed by systematically identifying comparative studies conducted until the end of June 2016 that investigated weight loss outcome and resolution of co-morbidities (type 2 diabetes mellitus, hypertension, hyperlipidemia, hypertriglyceridemia, and obstructive sleep apnea) with LRYGB and LSG in the midterm (3-5 years) and long term (≥5 years)...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Guohui Wang, Liyong Zhu, Weizheng Li, Xiangwu Yang, Pengzhou Li, Shaihong Zhu
BACKGROUND: The efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes mellitus (T2D) is closely associated with the preoperative body mass index (BMI) of the patient. There is a lack of long-term and large sampling evidence on the efficacy of LRYGB in T2D patients with low BMI in China. OBJECTIVES: This retrospective study aimed to evaluate the efficacy of surgical treatment in a Chinese population with T2D (especially patients with BMI<27...
July 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric 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
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
Mario Masrur, Luis Fernando Gonzalez-Ciccarelli, Pier C Giulianotti
No abstract text is available yet for this article.
August 4, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Marc Dilauro, Matthew D F McInnes, Nicola Schieda, Ania Z Kielar, Raman Verma, Cynthia Walsh, Andrey Vizhul, William Petrcich, Joseph Mamazza
Purpose To evaluate the accuracy of computed tomography (CT) for diagnosis of internal hernia (IH) in patients who have undergone laparoscopic Roux-en-Y gastric bypass and to develop decision tree models to optimize diagnostic accuracy. Materials and Methods This was a retrospective, ethics-approved study of patients who had undergone laparoscopic Roux-en-Y gastric bypass with surgically confirmed IH (n = 76) and without IH (n = 78). Two radiologists independently reviewed each examination for the following previously established CT signs of IH: mesenteric swirl, small-bowel obstruction (SBO), mushroom sign, clustered loops, hurricane eye, small bowel behind the superior mesenteric artery, and right-sided anastomosis...
September 30, 2016: Radiology
Joana Guimarães, Daniela Pinho, Catarina S Nunes, Carla S Cavaleiro, Humberto S Machado
STUDY OBJECTIVE: Pathophysiological changes after laparoscopic Roux-en-Y gastric bypass may increase the risk of pulmonary complications in morbidly obese patients. The purpose of the study was to assess the impact of immediate postextubation use of Boussignac continuous positive airway pressure (CPAP) on arterial oxygenation in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass. The hypothesis is that the use of CPAP may improve oxygenation in the postoperative period when compared to Venturi mask...
November 2016: Journal of Clinical Anesthesia
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
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