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https://www.readbyqxmd.com/read/29333067/complications-of-staple-line-and-anastomoses-following-laparoscopic-bariatric-surgery
#1
REVIEW
Gianfranco Silecchia, Angelo Iossa
With over 600 million people being obese, and given the scientific demonstration of the advantages of surgical treatment, bariatric surgery is on the rise. The promising long-term results in terms of weight loss, and particularly in relation to comorbidities and the control/cure rate, mean that the number of procedures performed in all countries remains high. However, the risk of potentially complex or fatal complications, though small, is present and is related to the procedures per se. This review is a guide for bariatric and/or general surgeons, offering a complete overview of the pathogenesis of anastomosis and staple line following the most common laparoscopic bariatric procedures: sleeve gastrectomy, gastric bypass, and mini-gastric bypass...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29313318/gastric-leaks-after-sleeve-gastrectomy-focus-on-pathogenetic-factors
#2
Francesco Frattini, Roberto Delpini, Davide Inversini, Vincenzo Pappalardo, Stefano Rausei, Giulio Carcano
As reported by The International Federation for the Surgery of Obesity (IFSO) worldwide survey on bariatric surgery, sleeve gastrectomy has become the second most performed bariatric/metabolic procedure in the world just after gastric bypass. If we consider complications, despite a recent systematic review and meta-analysis that reported a substantial decrease in sleeve gastrectomy complication rates, leaks after sleeve gastrectomy still rate between 0 and 18%. Unlike the leaks of other types of gastrointestinal surgery, leaks after sleeve gastrectomy are challenging in diagnosis and treatment and can lead to sepsis, multiple organ failure, and even death...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29310815/endoluminal-stenting-for-the-management-of-leak-following-sleeve-gastrectomy-and-loop-duodenojejunal-bypass-with-sleeve-gastrectomy
#3
Ying-Nan Tsai, Hsiu-Po Wang, Chih-Kun Huang, Po-Chin Chang, I-Chang Lin, Chi-Ming Tai
Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy...
January 2018: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29277390/guiding-the-non-bariatric-surgeon-through-complications-of-bariatric-surgery
#4
N Contival, B Menahem, T Gautier, Y Le Roux, A Alves
Complications in bariatric surgery are varied; they are severe at times but infrequent. They may be surgical or non-surgical, and may occur early or late. The goal of this systematic review is to inform and help the attending physician, the emergency physician and the non-bariatric surgeon who may be called upon to manage surgical complications that arise after adjustable gastric band (AGB), sleeve gastrectomy (SG), or gastric bypass (GBP). Data from evidence-based medicine were extracted from the literature by a review of the Medline database and also of the most recent recommendations of the learned societies implicated...
December 22, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29249586/medium-to-long-term-outcomes-of-bariatric-surgery-in-older-adults-with-super-obesity
#5
Aly Elbahrawy, Alexandre Bougie, Sarah-Eve Loiselle, Sebastian Demyttenaere, Olivier Court, Amin Andalib
BACKGROUND: Indications and outcomes of bariatric surgery in older adults suffering from morbid obesity remain controversial. We aimed to evaluate safety and medium to long-term outcomes of bariatric procedures in this patient population. SETTING: University Hospital, Canada. METHODS: This is a single-center retrospective study of a prospectively collected database. We included patients aged ≥60 years who underwent sleeve gastrectomy, Roux-en-Y gastric bypass, or biliopancreatic diversion with duodenal switch between January 2006 and December 2014 and had at least 2 years of follow-up...
November 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29248980/delayed-intra-splenic-abscess-a-specific-complication-following-laparoscopic-sleeve-gastrectomy
#6
Fajer Nassour, Naim Michel Schoucair, Hadrien Tranchart, Sophie Maitre, Ibrahim Dagher
BACKGROUND: Delayed intra splenic abscess after laparoscopic sleeve gastrectomy (LSG) is a very rare complication with poor manifestations. METHODS: We present three cases of delayed intrasplenic abscess which were managed in our departmentof minimal invasive surgery. DISCUSSION: Splenic abscess may occur in the early post-operative period following LSG; it is usually an extra splenic event after the gastric leak or an infected hematoma. In our cases, two patients had an asymptomatic ischemic demarcation in the upper part of the spleen...
December 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29246457/the-effectiveness-and-safety-of-laparoscopic-sleeve-gastrectomy-with-different-sizes-of-bougie-calibration-a-systematic-review-and-meta-analysis
#7
REVIEW
Yao Wang, Xiao-Yan Yi, Li-Lin Gong, Qi-Fu Li, Jun Zhang, Zhi-Hong Wang
OBJECTIVES: This systematic review and meta-analysis was performed to compare the influence of different calibrating bougie sizes on clinical outcomes in laparoscopic sleeve gastrectomy (LSG) for patients with obesity. MATERIALS AND METHODS: A systematic review of the literature was performed using the key words: "laparoscopic sleeve gastrectomy", "bougie size", "calibration", "obesity", and "obese" for searches of electronic databases up to October 2017. Clinical characteristics such as, the percentage of excess weight loss (%EWL), overall complications, gastrointestinal leaks, gastroesophageal reflux disease (GERD) were pooled by meta-analysis...
December 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29237137/endoscopic-abscess-septotomy-a-less-invasive-approach-for-the-treatment-of-sleeve-gastrectomy-leaks
#8
Camila B Ortega, Alfredo D Guerron, Dana Portenier
BACKGROUND: Postoperative leaks develop in a low percentage of patients undergoing laparoscopic sleeve gastrectomy (LSG), representing a rare yet devastating postoperative complication increasing morbidity and hospital stay. Leaks can become collections and may be very difficult to manage. Several therapeutic options with variable results, including surgical and nonsurgical methods have been described. Endoscopic abscess septotomy is an alternative method recently performed by a few centers reporting efficacy and safety outcomes...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29235015/use-of-self-expandable-metal-stents-in-the-treatment-of-leaks-complicating-laparoscopic-sleeve-gastrectomy-a-cohort-study
#9
Majid Abdularahman Almadi, Fahad Bamihriz, Othman Alharbi, Nahla Azzam, Ahmed Aljammaz, Mohanned Eltayeb, Salem Thaniah, Abdullah Aldohayan, Abdulrahman Aljebreen
BACKGROUND: Use of a self-expandable metal stent (SEMS) as an initial intervention for leaks after laparoscopic sleeve gastrectomy (LSG) has increased. We assessed the efficacy and safety of SEMS in the treatment of post-LSG leaks, and the determinants of repeated rounds of stenting. METHODS: A retrospective chart review was conducted at a university hospital in Saudi Arabia. The study included patients who developed leaks after undergoing LSG between October 2011 and April 2016...
December 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29197192/laparoscopic-gastric-plication-for-the-treatment-of-morbid-obesity-by-using-real-time-imaging-of-the-stomach-pouch
#10
Cristian Borz, Tivadar Jr Bara, Tivadar Bara, Andras Suciu, Marton Denes, Bogdan Borz, Dorin Marian, Simona Muresan, Anca Bacarea, Mircea Muresan, Gabriela Jimborean
BACKGROUND: Bariatric surgery is a continuously evolving field. Laparoscopic greater curvature plication is a new investigational procedure used to treat patients with morbid obesity. The demand for this operation from the obese patients is also rising. The problem is that during gastric plication the exact dimensions and volume of the pouch are not known so frequently it is too large or too tight thus compromising the results. The aim of the study was to identify the parameters that can improve the outcomes after this procedure...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29182900/laparoscopic-sleeve-gastrectomy-for-morbid-obesity-role-of-intraluminal-and-intraperitoneal-postoperative-drainage
#11
G Currò, G Piscitelli, C Lazzara, I Komaei, A Fortugno, G Pinto, F Guccione, A Cogliandolo, A Dattola, S Latteri, G Navarra
BACKGROUND AND AIMS: Bleeding and staple line leak are the most common postoperative complications of LSG. To prevent and/or to promptly identify such complications, conventional peri-operative protocols imply post-operative gastric decompression (NGT) and staple line drain (IAD). Our aim was to evaluate the role of naso-gastric tube (NGT) and intra-abdominal drain (IAD) in preventing and/or facilitating identification and treatment of post-operative complications after sleeve gastrectomy...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#12
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29122706/mid-to-long-term-outcomes-of-laparoscopic-sleeve-gastrectomy-in-indian-population-3-7-year-results-a-retrospective-cohort-study
#13
Harshit Garg, Sandeep Aggarwal, Mahesh Chandra Misra, Pratyusha Priyadarshini, Ashish Swami, Lokesh Kashyap, Richa Jaiswal
INTRODUCTION: Few studies have addressed the mid to long term impact of Laparoscopic Sleeve Gastrectomy (LSG) on weight loss and obesity associated co-morbidities, particularly in Indian population. The aim of this study is to assess the efficacy of LSG in morbid obesity over 3-7 years follow up. MATERIALS AND METHODS: Data of all patients who underwent LSG between January 2008 and March 2015 and completed their at least 1 year follow up till March 2016 was retrospectively reviewed using a prospectively collected database...
November 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29099314/outcomes-in-super-obese-patients-undergoing-laparoscopic-sleeve-gastrectomy
#14
Vitish Singla, Sandeep Aggarwal, Harshit Garg, Lokesh Kashyap, Dilip R Shende, Samagra Agarwal
BACKGROUND: Super obese patients remain a challenge for management because of large liver size resulting in decreased work space and associated comorbidities. OBJECTIVES: To study outcomes in super obese patients undergoing Laparoscopic sleeve gastrectomy (LSG). METHODS: Retrospective data of 123 patients undergoing LSG from January 2008 to March 2015 were analyzed prospectively. RESULTS: Mean age and body mass index (BMI) of 123 patients (± 2 standard deviation [SD]) were 39...
November 3, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29091018/seal-or-drain-endoscopic-management-of-leaks-following-sleeve-gastrectomy
#15
Gianfranco Donatelli, David Fuks, Nicolas Tabchouri, Guillaume Pourcher
No abstract text is available yet for this article.
October 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29079385/the-role-of-routine-abdominal-drainage-after-bariatric-surgery-a-metabolic-and-bariatric-surgery-accreditation-and-quality-improvement-program-study
#16
Aristithes G Doumouras, Azusa Maeda, Timothy D Jackson
BACKGROUND: The efficacy of drains has long been debated in bariatric surgery. Drains may provide some theoretical benefits to early detection of anastomotic leaks and potential nonoperative treatment; however, there has never been data to support the practice. OBJECTIVE: The objective of this study was to evaluate the effect of drain placement after bariatric surgery. SETTING: This retrospective cohort study includes all hospitals in the United States that participated in the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program...
August 31, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29071067/the-birmingham-experience-of-high-pressure-methylene-blue-dye-test-during-primary-and-revisional-bariatric-surgery-a-retrospective-cohort-study
#17
G C Kirby, C A W Macano, S M Nyasavajjala, M Sahloul, R Nijjar, M Daskalakis, M Richardson, R Singhal
INTRODUCTION: Leak following bariatric surgery continues to be associated with morbidity and rarely mortality. With improvement in surgical techniques and stapler design, leak rates have reduced drastically. Intra-operative high pressure Methylene blue leak test (HPMB) is one of the techniques employed to confirm integrity of anastomoses and staple lines. Despite this, evidence for its use remains limited. We evaluated the role of HPMB in detecting and preventing leaks. METHODS: A retrospective cohort of consecutive patients who underwent primary or revisional Laparoscopic Sleeve Gastrectomy (SG) or Laparoscopic Roux-en-Y Gastric bypass (RYGB) under the care of five surgeons in three centres across Birmingham, UK, between 2012 and 2016 were assessed...
November 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29052063/endoscopic-treatment-of-leaks-after-laparoscopic-sleeve-gastrectomy-using-mega-esophageal-covered-stents
#18
Tomasz Klimczak, Jerzy Klimczak, Tomasz Szewczyk, Przemysław Janczak, Piotr Jurałowicz
BACKGROUND: Sleeve gastrectomy has become one of the main bariatric procedures over the last few years. This can be explained by the relative simplicity and high effectiveness of this method. Yet, it causes complications as any other method. Staple line leaks are the most frequent ones. According to different sources, this complication may occur with 0-7% frequency. Until 2013, surgery was the only effective treatment method for this complication. However, reoperations considerably increased treatment cost and patient morbidity...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29029355/over-sewing-of-staple-line-in-laparoscopic-sleeve-gastrectomy-initial-experience-of-a-comparative-study
#19
Giorgio Lisi, Roberto Rossini, Irene Gentile, Giacomo Ruffo
INTRODUCTION: The main drawback of laparoscopic sleeve gastrectomy (LSG) is the severity of postoperative complications. Staple line reinforcement (SLR) is strongly advocated. Recently, over-sewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. The purpose of this study was to report our initial experience with LSG comparing over-sewing over the entire staple line with the upper-third staple line. MATERIALS AND METHODS: All obese patients seen at Negrar Sacro Cuore, Don Calabria Hospital were entered into our prospective database and were retrospectively evaluated...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28975492/sleeve-gastrectomy-outcomes-in-patients-with-bmi-between-30-and-35-3-years-of-follow-up
#20
Marcos A Berry, Lionel Urrutia, Patricio Lamoza, Alfredo Molina, Eduardo Luna, Federico Parra, María J Domínguez, Rodrigo Alonso
INTRODUCTION AND PURPOSE: Laparoscopic sleeve gastrectomy (LSG) in patients with a BMI between 30 and 35 kg/m(2) plus comorbidities has shown to be safe and effective. The purpose of this study is to describe our outcomes in this group of patients after 3 years of follow-up. MATERIALS AND METHODS: Retrospective descriptive analysis of patients with initial BMI between 30 and 35 kg/m(2) plus comorbidities were submitted to LSG between 2006 and 2013. We analyzed gender, age, comorbidities, BMI, total weight loss (%TWL), excess weight loss (%EWL), comorbidity resolution, morbidity, and mortality...
October 4, 2017: Obesity Surgery
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