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bariatric endoscopy

Romano Schneider, Ioannis Lazaridis, Marko Kraljević, Christoph Beglinger, Bettina Wölnerhanssen, Ralph Peterli
BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Ionuţ Hutopilă, A Constantin, Cătălin Copăescu
Background: Obesity has significantly increased in the last decades and metabolic (bariatric) surgery has been extended accordingly. Clinical manifestations of Gastroesophageal reflux disease (GERD) are frequent in the obese population but the presence of GERD premises (i.e. Hiatala hernia) or complications in asymptomatic patients undergoing metabolic surgery is unclear. AIM: (1) to identify gastroesophageal reflux condition or complications in patients undergoing metabolic surgery. (2) Study the correlations of the clinical symptoms of GERD with the preoperative radiological and endoscopic findings...
January 2018: Chirurgia
Eugene Y Wang, Timothy R Shope
To raise awareness for surgeons encountering bariatric patients with anatomy that deviates from the standard Roux-en-Y gastric bypass (RYGB). This is a single-institution retrospective case series over 12 years (2003-2014) involving patients who believed they received RYGBs, but actually did not. Data was obtained reviewing physician encounters, imaging, and operative reports. There were six cases with confusing clinical pictures, found to have aberrant RYGB anatomy: (1) gastric bypass with jejuno-jejunostomy only without gastrojejunostomy, (2) distal partial vertical gastrectomy without expected prosthetic band, (3) inverse vertical banded gastroplasty, (4) non-divided gastric bypass with no gastrojejunostomy, (5) 20-cm Roux limb, with gastro-gastric fistula, and (6) 200-cm bilio-pancreatic limb similar to the traditional Scopinaro procedure...
March 5, 2018: Obesity Surgery
Jaanus Suumann, Toomas Sillakivi, Živile Riispere, Kari Syrjänen, Pentti Sipponen, Ülle Kirsimägi, Ants Peetsalu
Background: To assess the value of serological biomarker testing as a substitute for esophagogastroduodenoscopy (EGDS) in pre-operative assessment of patients referred for bariatric surgery. Methods: Sixty-five obese patients with a mean age of 43 years (range: 21-65) and a mean body mass index (BMI) of 44 (range: 36-59) were studied. The patients were tested with a four-biomarker panel: pepsinogen I and II, gastrin-17 (basal and stimulated), and Helicobacter pylori (HP) antibodies (GastroPanel®, Biohit Oyj, Finland)...
2018: BMC Obesity
G Böhm
BACKGROUND: The radiological evaluation of the upper gastrointestinal tract (GI tract) is a diagnostic challenge. Although endoscopy has pushed radiographic methods into the background, these methods continue to play a key role in the diagnosis of dysphagia. In addition, cross-sectional imaging (computed tomography, magnetic resonance imaging) is increasingly used in complex clinical cases to evaluate surrounding tissue changes. METHODS: By combining conventional double-contrast techniques with a video recording, the entire upper GI tract can be assessed both anatomically and functionally in one examination procedure...
February 23, 2018: Der Radiologe
Francesco Tartamella, Gabriele Petracca, Andrea Romboli, Federico Marchesi
The endoscopic inaccessibility of the gastric remnant after Roux-en-Y gastric bypass (RYGBP) for morbid obesity represents an important issue for patients with familiar history of gastric cancer (GC) or affected by premalignant lesions, such as intestinal metaplasia. If a different bariatric procedure is contraindicated, RYGBP with remnant gastrectomy represents a reasonable alternative, significantly reducing the risk of GC but potentially increasing postoperative morbidity. For this reason, only few cases have been reported in the recent Literature and none regarding a super-super obese patient...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
Joshua J Weis, Matthew Goldblatt, Aurora Pryor, Brian J Dunkin, L Michael Brunt, Daniel B Jones, Daniel J Scott
BACKGROUND: The American health care system faces deficits in quality and quantity of surgeons. SAGES is a major stakeholder in surgical fellowship training and is responsible for defining the curriculum for the Advanced GI/MIS fellowship. SAGES leadership is actively adapting this curriculum. METHODS: The process of reform began in 2014 through a series of iterative meetings and discussions. A working group within the Resident and Fellow Training Committee reviewed case log data from 2012 to 2015...
January 17, 2018: Surgical Endoscopy
Adel Alhaj Saleh, Michal R Janik, Rami R Mustafa, Mohammed Alshehri, Adil H Khan, Seyed Mohammad Kalantar Motamedi, Shiraz Rahim, Indravadan Patel, Amir Aryaie, Mujjahid Abbas, Tomasz Rogula, Leena Khaitan
INTRODUCTION: Sleeve gastrectomy (SG) is one of the most common procedures performed for weight loss. Many seek the "perfect sleeve" with the notion that the type of calibrating device affects sleeve shape, and this in turn will affect outcomes and complications. Two major concerns after SG are amount of weight loss and acid reflux. Our aim was to determine if the various calibration methods could impact sleeve shape and thereby allow for better outcomes of weight loss and reflux. METHODS: A retrospective chart review was performed of 210 patients who underwent SG and had postoperative upper gastrointestinal (UGI) study from 2011 to 2015 in a single center by a single (fellowship-trained) bariatric surgeon...
January 8, 2018: Obesity Surgery
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
Ammiel Martínez Canil, Angelo Iossa, Pietro Termine, Daniela Caporilli, Vincenzo Petrozza, Gianfranco Silecchia
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained popularity in the last 10 years for its good results in weight loss and comorbidity control. However, guidelines on the pathological examination of the specimen are lacking. The aim of this retrospective study was to determine the usefulness of the routine specimen examination when presurgery endoscopy (upper gastrointestinal endoscopy, UGIE) and multiple gastric biopsies are part of the preoperative work-up. METHODS: A retrospective review of records of the patients submitted to LSG between January 2012 and August 2017 was carried out...
January 5, 2018: Obesity Surgery
Salman Alsabah, Eliana Al Haddad, Shehab Ekrouf, Ahmad Almulla, Saud Al-Subaie, Mubarak Al Kendari
BACKGROUND: Obesity is on a continuous rise worldwide, and with it, novel bariatric procedures have emerged. The introduction of gastric balloons has opened up a nonsurgical option for patients opting for it. However, they still require some form of sedation and endoscopy for insertion and/or removal. OBJECTIVES: The Elipse balloon is a novel creation that has managed to bypass both these procedures; therefore, the investigation into its effectiveness is of importance...
December 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
G Martines, A Picciariello, I Ugenti, E Lagovardou, R Digennaro, P Capuano
AIM: Laparoscopic adjustable gastric banding (LAGB) migration is an uncommon late complication after bariatric surgery. It usually presents with an unexplained weight increase or without any symptom. Current guidelines do not establish the timing of a clear endoscopic follow-up to prevent and/or to treat this kind of complication. PATIENTS AND METHODS: Long-term follow-up was performed in 217 patients with LAGB (37 underwent surgery in other bariatric centers). At the endoscopic check, 3 patients presented banding erosion respectively 7, 9 and 11 years after surgery...
September 2017: Il Giornale di Chirurgia
Serdar Yormaz, Huseyin Yilmaz, Husnu Alptekin, Ilhan Ece, Fahrettin Acar, Bayram Colak, Mehmet Ertugrul Kafali, Enes Sahin, Mustafa Sahin
AIM: Performance of routine preoperative esophagogastroduodenal endoscopy (EGE) in patients undergoing bariatric surgery is still a controversial subject. The purpose of our study was to evaluate the benefits of performing preoperative EGE in a cohort of bariatric patients. MATERIAL AND METHODS: The present retrospective study was performed between March 2010 and June 2016. We divided the study participants into two groups: group A comprised subjects without disturbing upper digestive signs, while group B comprised patients with disturbing upper digestive signs...
November 29, 2017: Annali Italiani di Chirurgia
Georgia Doulami, Stamatina Triantafyllou, Konstantinos Albanopoulos, Maria Natoudi, Georgios Zografos, Dimitrios Theodorou
BACKGROUND: Single anastomosis gastric bypass (SaGB) was introduced in 2001 as an alternative to "loop" gastric bypass. It was considered as a procedure that would eliminate alkaline reflux and associated esophagitis. OBJECTIVES: Existing evidence about the postoperative incidence of gastroesophageal reflux (GERD) after SaGB is based on studies using symptom questionnaires. The aim of our study was to evaluate GERD 12 months after SaGB by using 24-hour multichannel intraluminal impedance pH metry (24-h MIIpH)...
October 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Krishnamurthy Somasekar, David S Y Chan, Nhatuveetil S Sreekumar, Salman Anwer
BACKGROUND: Gallstone disease is common after bariatric surgery, and patients with bile duct stones in this cohort can be difficult to treat, due to the altered anatomy. This review aims to analyse the various management options available for choledocholithiasis in post-bariatric surgery patients. METHODS: A literature search of PubMed, Medline and Cochrane library databases was carried out for studies on this subject, between January 1970 and March 2017. After initial screening and further full text review, suitable studies were identified after applying the inclusion criteria...
November 30, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
José Manuel Reis Santos
Stone surgery is one of oldest surgical practices undertaken by man. Hippocrates refused to let his followers "cut for the stone" and it was only in February 1980, when the first human trial of shock wave therapy on a renal stone was performed with success that a new era in minimally invasive treatment (surgery) for stones was opened up and this condemnation was finally resolved in the Hippocratic Oath. Endoscopy, using natural orifices, supported by anaesthesia, incremented by technology and with access to all points along the urinary tract, began by competing with ESWL, but is now the treatment of choice in most cases...
February 2018: Urolithiasis
Eduardo Espinet Coll, Javier Nebreda Durán, Gontrand López-Nava Breviere
Recently, the Elipse® swallow balloon with spontaneous evacuation has been incorporated. GETTEMO wants to position defending innovations in endoscopic treatment of bariatric patients, including this new gastric balloon. Any bariatric endoscopic procedure must always be done within a suitable protocol and in a Multidisciplinary Unit. In order to ensure maximum safety and to be able to effectively solve potential complications, in most of the cases a prior endoscopy should be required to rule out complications, the balloon must be implanted (or supervised) by a bariatric endoscopist and it is necessary to have an Endoscopic Emergency Department...
November 23, 2017: Revista Española de Enfermedades Digestivas
Shireesh Saurabh
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Lack of clinical symptoms and findings on preoperative upper endoscopy makes its diagnosis difficult in bariatric patients. A laparoscopic resection of the gastric GIST during bariatric surgery is associated with good long-term prognosis.
November 2017: Clinical Case Reports
Tobias Schlosser, Juergen Feisthammel, Joachim Moessner, Albrecht Hoffmeister
Prevalence and incidence of obesity in the population has been increasing for decades. Due to associated comorbidities, treatment of obesity has become a global health topic and should be addressed with multimodal strategies. As conservative treatment has high rates of failure, bariatric surgery is often performed, especially in cases of severe obesity. However, interventional endoscopic options are gaining importance as less invasive approach. Intragastric balloons and duodenojejunal bypass liners are the most frequent applied endoscopic therapies...
December 2017: Minerva Chirurgica
Javier Nebreda Durán, Eduard Espinet Coll
Dear Editor, We would like to clarify certain points in the article by C. Dolz et al. entitled "Informed consent in digestive endoscopy - Patient information, endoscopist protection", more specifically regarding the section "Obesity treatments". First, we want to congratulate the authors for their highly relevant yearlong research of the medico-legal aspects of Spanish endoscopy and for sharing their knowledge with endoscopists on a national level. With regard to the endoscopic management of obesity, we consider that the informed consent process should be even more comprehensive than that with other endoscopic techniques...
December 2017: Revista Española de Enfermedades Digestivas
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