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Gastric Bypass Surgery

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https://www.readbyqxmd.com/read/29164509/evolution-and-standardisation-of-techniques-in-single-incision-laparoscopic-bariatric-surgery
#1
P Praveen Raj, Siddhartha Bhattacharya, R Parthasarathi, P Senthilnathan, S Rajapandian, S Saravana Kumar, C Palanivelu
Bariatric surgery has proven benefits for morbid obesity and its associated comorbidities. Laparoscopic approach is well established for bariatric surgery. Single-incision laparoscopic surgery (SILS) offers even more minimally invasive approach for the same with the added advantage of better cosmesis. We have developed and standardised the SILS approach at our institute. We share our experience and technical "tips" and modifications which we have learnt over the years. Technical details of performing sleeve gastrectomy and Roux-en-Y gastric bypass with special attention to liver retraction, techniques of dissection in difficult areas, creation of anastomoses and suturing have all been described...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29164508/eus-guided-transrectal-evacuation-of-organized-pelvic-collection-following-roux-en-y-gastric-bypass-after-failure-of-radiological-and-surgical-approach
#2
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Bruto Randone, Bruno Meduri, Panagiotis Lainas, Hadrien Tranchart, Ibrahim Dagher
INTRODUCTION: Postoperative collections are an important cause of morbidity following obesity surgery. Surgical revision is most often required if general sepsis is present. Conservative treatment consists of broad spectrum antibiotics and percutaneous drainage of any collection. EUS drainage is a new technique that is gaining momentum allowing an easy access to collections close to the GI tract. MATERIALS AND METHODS: We present the case report of a 39-year-old woman who underwent to robotic Roux-en-Y gastric bypass for morbid obesity...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29164159/gastric-pouch-mixed-adenoneuroendocrine-carcinoma-with-a-mixed-adenocarcinoma-component-after-roux-en-y-gastric-bypass
#3
Ricardo G Pastorello, Mariana Petaccia de Macedo, Wilson Luiz da Costa Junior, Maria Dirlei F S Begnami
The Roux-en-Y gastric bypass is one of the most common procedures currently performed for surgical treatment of patients with severe obesity. Gastric cancer after bariatric surgery is not common, with most of them arising in the excluded stomach. Gastric mixed adenoneuroendocrine carcinomas are a rare type of stomach malignancy, composed of both adenocarcinoma and neuroendocrine tumor-cell components, with the latter comprising at least 30% of the whole neoplasm. In this article, we report a unique case of a mixed adenoneuroendocrine carcinoma with a mixed adenocarcinoma (tubular and poorly cohesive) component arising in the gastric pouch of a patient who underwent previous Roux-en-Y gastric bypass for glycemic control...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29162605/changes-in-high-density-lipoprotein-cholesterol-efflux-capacity-after-bariatric-surgery-are-procedure-dependent
#4
Sean P Heffron, BingXue Lin, Manish Parikh, Bianca Scolaro, Steven J Adelman, Heidi L Collins, Jeffrey S Berger, Edward A Fisher
OBJECTIVE: High-density lipoprotein cholesterol efflux capacity (CEC) is inversely associated with incident cardiovascular events, independent of high-density lipoprotein cholesterol. Obesity is often characterized by impaired high-density lipoprotein function. However, the effects of different bariatric surgical techniques on CEC have not been compared. This study sought to determine the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on CEC. APPROACH AND RESULTS: We prospectively studied severely obese, nondiabetic, premenopausal Hispanic women not using lipid medications undergoing RYGB (n=31) or SG (n=36)...
November 21, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29159553/revisional-malabsorptive-bariatric-surgery-29-year-follow-up-in-a-brazilian-public-hospital
#5
Katia Pires Souto, Nelson Guardiola Meinhardt, Isabella de Azevedo Dossin, Mauricio Jacques Ramos, Greyce Carnellos, Cristina Mazzaferro, Paulo Renato Assis Brasil, Daniel C Damin
BACKGROUND: This study aimed to evaluate the outcomes of 67 patients who underwent revisional bariatric surgeries over a 29-year period in a Brazilian public hospital. METHODS: The records of all patients who underwent revisional bariatric surgery from January 1987 to December of 2016 at our hospital were analyzed for weight loss and complications. Descriptive statistics and paired t tests were computed. RESULTS: Sixty-seven patients were included in the study...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29157916/the-effect-of-bariatric-surgery-on-direct-acting-oral-anticoagulant-drug-levels
#6
Amihai Rottenstreich, Aviv Barkai, Ariela Arad, Bruria Hirsh Raccah, Yosef Kalish
OBJECTIVE: To determine direct-acting oral anticoagulant (DOAC) blood levels in post-bariatric surgery (BS) patients treated with long-term anticoagulation therapy. METHODS: We identified from medical records patients who underwent BS during 2005-2016 and who were treated with DOACs. We offered testing DOAC blood levels to these patients and to age, sex, body mass index, and serum creatinine-matched individuals treated by DOACs who did not undergo BS. RESULTS: Overall, 36 individuals were enrolled, 18 post-BS patients and 18 control subjects...
November 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#7
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29152839/beta-cell-sensitivity-to-glucose-is-impaired-after-gastric-bypass-surgery
#8
Marzieh Salehi, Amalia Gastaldelli, David A D'Alessio
AIMS: Patients with Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here we sought to determine β-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors. MATERIALS AND METHODS: Twelve non-diabetic subjects with prior GB, and 7 matched non-surgical controls with normal glucose tolerance were studied...
November 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29150392/improvement-in-quality-of-life-after-bariatric-surgery-sleeve-versus-bypass
#9
Dirk P A Versteegden, Magaly J J Van Himbeeck, Simon W Nienhuijs
BACKGROUND: Obesity is steadily growing to be the largest threat to human health in this century, not only increasing prevalence of obesity-related co-morbidity but also impairing health-related quality of life (QoL). Bariatric surgery has shown to improve co-morbidity as well as QoL. OBJECTIVES: To assess the differences in improvement in QoL for the 2 most performed procedures: laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB)...
October 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#10
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145284/effectiveness-of-bariatric-surgical-procedures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#11
Jenny H Kang, Quang A Le
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs. METHODS: The present study was a systematic review and network meta-analysis of RCTs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#12
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29138180/inhibition-of-vascular-c-jun-n-terminal-kinase-2-improves-obesity-induced-endothelial-dysfunction-after-roux-en-y-gastric-bypass
#13
Petia Doytcheva, Thomas Bächler, Erika Tarasco, Vincenzo Marzolla, Michael Engeli, Giovanni Pellegrini, Simona Stivala, Lucia Rohrer, Francesco Tona, Giovanni G Camici, Paul M Vanhoutte, Christian M Matter, Thomas A Lutz, Thomas F Lüscher, Elena Osto
BACKGROUND: Roux-en-Y gastric bypass (RYGB) reduces obesity-associated comorbidities and cardiovascular mortality. RYGB improves endothelial dysfunction, reducing c-Jun N-terminal kinase (JNK) vascular phosphorylation. JNK activation links obesity with insulin resistance and endothelial dysfunction. Herein, we examined whether JNK1 or JNK2 mediates obesity-induced endothelial dysfunction and if pharmacological JNK inhibition can mimic RYGB vascular benefits. METHODS AND RESULTS: After 7 weeks of a high-fat high-cholesterol diet, obese rats underwent RYGB or sham surgery; sham-operated ad libitum-fed rats received, for 8 days, either the control peptide D-TAT or the JNK peptide inhibitor D-JNKi-1 (20 mg/kg per day subcutaneous)...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29137169/pancreatic-exocrine-insufficiency-after-bariatric-surgery
#14
REVIEW
Miroslav Vujasinovic, Roberto Valente, Anders Thorell, Wiktor Rutkowski, Stephan L Haas, Urban Arnelo, Lena Martin, J-Matthias Löhr
Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult...
November 13, 2017: Nutrients
https://www.readbyqxmd.com/read/29135972/roux-en-y-gastric-bypass-reduces-plasma-cholesterol-in-diet-induced-obese-mice-by-affecting-trans-intestinal-cholesterol-excretion-and-intestinal-cholesterol-absorption
#15
C Blanchard, F Moreau, A Ayer, L Toque, D Garçon, L Arnaud, F Borel, A Aguesse, M Croyal, M Krempf, X Prieur, M Neunlist, B Cariou, C Le May
OBJECTIVE: Bariatric surgery appears as the most efficient therapeutic alternative in morbidly obese patients. In addition to its efficiency to decrease body weight, it also improves metabolic complications associated to morbid obesity, including dyslipidemia. Although the cholesterol-lowering effect varies with the bariatric procedures, the underlying molecular mechanisms remain poorly defined. This study aims to assess the consequence of both restrictive (sleeve gastrectomy; SG) and malabsorptive (Roux-en-Y gastric bypass; RYGB) procedures on cholesterol metabolism in mice...
September 28, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29134499/correction-to-trend-of-changes-in-serum-albumin-and-its-relation-with-sex-age-and-bmi-following-laparoscopic-mini-gastric-bypass-surgery-in-morbid-obese-cases
#16
Mehrdad Karimi, Ali Kabir, Masoumeh Nejatifar, Abdolreza Pazouki
Due to a production error the bottom portion of Fig. 3 was missing in the version of this article originally published online.
November 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#17
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m(2) Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29127578/comparative-outcomes-of-bariatric-surgery-in-patients-with-and-without-human-immunodeficiency-virus
#18
Gautam Sharma, Andrew T Strong, Mena Boules, Chao Tu, Samuel Szomstein, Raul Rosenthal, John Rodriguez, Alan J Taege, Matthew Kroh
BACKGROUND: Paradoxically, advances in anti-retroviral therapy that has increased survival for patients with human immunodeficiency virus (HIV) have resulted in greater numbers of HIV+ patients developing other chronic diseases, including obesity. Little comparative literature exists detailing perioperative or metabolic outcomes of bariatric surgery in the HIV+ population compared to HIV negative (HIV-) controls. METHODS: This is a retrospective case-control study with both HIV+ (case) and HIV- control patients...
November 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29122527/implementation-of-enhanced-recovery-programs-for-bariatric-surgery-results-from-the-francophone-large-scale-database
#19
Anissa Deneuvy, Karem Slim, Maxime Sodji, Pierre Blanc, Denis Gallet, Marie-Cécile Blanchet
BACKGROUND: The feasibility, safety, and efficacy of programs for enhanced recovery after bariatric surgery (ERABS) are now well established. However, data concerning their large-scale implementation remain insufficient. OBJECTIVES: The objective of the present study was to review the multicenter implementation of ERABS SETTING: This retrospective analysis of a prospective database was conducted in 15 Groupe francophone de Rehabilitation Améliorée après ChirurgiE centers from data from March 2014 to January 2017...
October 4, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29120924/potential-mechanisms-underlying-the-effect-of-bariatric-surgery-on-eating-behaviour
#20
Roxanna Zakeri, Rachel L Batterham
PURPOSE OF REVIEW: Reduced energy intake, resulting from favourable changes in eating behaviour, is the predominant driver of weight loss following bariatric surgery. Here we review the most recent studies examining the impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy, the two most common bariatric procedures, upon eating behaviour and the suggested underlying biological mechanisms. RECENT FINDINGS: Following RYGB or sleeve gastrectomy, most people report subjective changes in appetite, taste and food preference, with decreased high-fat preference most commonly reported...
November 7, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
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