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Roux en Y Gastric Bypass

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https://www.readbyqxmd.com/read/28930514/weight-and-metabolic-outcomes-12-years-after-gastric-bypass
#1
Ted D Adams, Lance E Davidson, Sheldon E Litwin, Jaewhan Kim, Ronette L Kolotkin, M Nazeem Nanjee, Jonathan M Gutierrez, Sara J Frogley, Anna R Ibele, Eliot A Brinton, Paul N Hopkins, Rodrick McKinlay, Steven C Simper, Steven C Hunt
BACKGROUND: Few long-term or controlled studies of bariatric surgery have been conducted to date. We report the 12-year follow-up results of an observational, prospective study of Roux-en-Y gastric bypass that was conducted in the United States. METHODS: A total of 1156 patients with severe obesity comprised three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2)...
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28929425/medium-term-outcomes-after-reversal-of-roux-en-y-gastric-bypass
#2
Gustavo Andrés Arman, J Himpens, R Bolckmans, D Van Compernolle, R Vilallonga, G Leman
BACKGROUND: Roux-en-Y gastric bypass (RYGB) can be reversed into normal anatomy (NA) or into sleeve gastrectomy (NASG) to address undesired side effects. Concomitant hiatal hernia repair (HHR) may be required. Before reversal, some patients benefit from placement of a gastrostomy, mostly to predict the result of recreating the native anatomy. METHODS: Retrospective study on mid-term effects of RYGB reversal to NA and NASG, including clinical and weight evolution, surgical complications, and incidence of gastro-esophageal reflux (GERD)...
September 19, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28929278/effect-and-mechanisms-of-diabetes-resolution-according-to-the-range-of-gastric-resection-and-the-length-of-anastomosis-in-animal-models-implication-for-gastric-cancer-surgery-in-patients-with-diabetes-mellitus
#3
Yeon-Ju Huh, Young-Gil Son, Tae-Han Kim, Ji-Ho Park, Tae-Jung Oh, Boram Choi, Jimin Min, Young Min Cho, Han-Kwang Yang, Hyuk-Joon Lee
BACKGROUND: To examine the effect and mechanism of Roux-en-Y gastric bypass (RYGB) on the improvement of diabetes according to the length of anastomosis and the gastric pouch volume in an animal model. METHODS: Glucose intolerance was induced with a high-fat diet for 3 months in Sprague-Dawley rats. The animals were subjected to conventional RYGB (cRYGB; 5% gastric pouch with 15-cm Roux limb, 40-cm biliopancreatic limb; n = 9), short-limb RYGB (sRYGB; 5%, 8, 4 cm; n = 9), fundus-sparing RYGB (fRYGB; 30%, 8, 4 cm; n = 9), or sham operation (n = 9)...
September 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28929218/percutaneous-gastric-remnant-gastrostomy-following-roux-en-y-gastric-bypass-surgery-a-single-tertiary-center-s-13-year-experience
#4
Shehbaz Hasam Shaikh, Justin Jay Stenz, David W McVinnie, James J Morrison, Todd Getzen, Arthur M Carlin, Farhaan R Mir
PURPOSE: The purpose of the study is to evaluate the indications, techniques, and outcomes for percutaneous gastrostomy placement in the gastric remnant following Roux-en-Y gastric bypass (RYGB) in bariatric patients. MATERIALS AND METHODS: Retrospective chart review and summary statistical analysis was performed on all RYGB patients that underwent attempted percutaneous remnant gastrostomy placement at our institution between April 2003 and November 2016. RESULTS: A total of 38 patients post-RYGB who underwent gastric remnant gastrostomy placement were identified, 32 women and 6 men, in which a total of 41 procedures were attempted...
September 19, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28928326/a-delayed-acute-complication-of-bariatric-surgery-gastric-remnant-haemorrhagic-ulcer-after-roux-en-y-gastric-bypass
#5
Stefan Patrascu, Carmen Balague Ponz, Sonia Fernandez Ananin, Eduardo M Targarona Soler
Acute gastric remnant bleeding is an exceptionally rare complication when it occurs long after bariatric surgery. We present the case of a patient with a bleeding ulcer of the excluded stomach (i.e., the remnant), occurring 7 years after Roux-en-Y gastric bypass (RYGB) for morbid obesity. A computed tomography scan managed to locate the active bleeding source in the gastric remnant. During emergency laparotomy, a bleeding ulcer of the fundic region of the excluded stomach was identified. Total resection of the remnant was performed, with good post-operative recovery...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28924918/adipocyte-size-and-leptin-receptor-expression-in-human-subcutaneous-adipose-tissue-after-roux-en-y-gastric-bypass
#6
Martha Tamez, Victoria Ramos-Barragan, Patricia Mendoza-Lorenzo, Pablo Arrieta-Joffe, Sergio López-Martínez, Martín E Rojano-Rodríguez, Mucio Moreno-Portillo, María E Frigolet
The molecular mechanisms implicated in pronounced weight loss and metabolic benefits after bariatric surgery are still unknown. Adipocyte phenotype and metabolism have not been entirely explored. However, some features of adipocyte function have been studied, such as adipocyte size and inflammation, which are both reduced after bariatric surgery. Adipocyte fat metabolism, which is partly regulated by leptin, is likely modified, since adipocyte area is decreased. Here, we show that leptin receptor expression is increased, while adipocyte size is decreased 8 months after Roux-en-Y gastric bypass...
September 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28921894/macrophage-area-content-and-phenotype-in-hepatic-and-adipose-tissue-in-patients-with-obesity-undergoing-roux-en-y-gastric-bypass
#7
Marianne D Kristensen, Michael T Lund, Merethe Hansen, Steen S Poulsen, Thorkil Ploug, Flemming Dela, Jørn W Helge, Clara Prats
OBJECTIVE: To investigate hepatic and adipose tissue macrophage content in subjects with obesity and the role of adipose tissue macrophages in weight loss-induced improved insulin sensitivity (IS). METHODS: A cross-sectional and a longitudinal study were combined to investigate the role of macrophages in subcutaneous (SAT) and visceral (VAT) adipose tissue and the liver in obesity-induced impaired IS and improvements with weight loss. Macrophage markers (CD68, CD163, and CD206) in SAT, VAT, and the liver from patients with obesity were investigated...
September 18, 2017: Obesity
https://www.readbyqxmd.com/read/28921422/high-incidence-of-secondary-hyperparathyroidism-in-bariatric-patients-comparing-different-procedures
#8
Jih-Hua Wei, Wei-Jei Lee, Keong Chong, Yi-Chih Lee, Shu-Chun Chen, Po-Hsun Huang, Shing-Jong Lin
BACKGROUND: Bariatric surgery is an effective therapy for morbid obesity but may reduce calcium absorption and significantly decrease the bone mineral density. This study examined the prevalence of secondary hyperparathyroidism (SHPT) in obese subjects during follow-up after different bariatric surgeries. We investigated predictors of SHPT. METHODS: We enrolled 1470 obese subjects undergoing bariatric/metabolic surgery with at least 1-year follow-up, including 322 patients undergoing Roux-en-Y gastric bypass (RYGB), 695 undergoing single anastomosis (mini-) gastric bypass (SAGB), 93 undergoing laparoscopic adjustable gastric banding (LAGB), and 360 undergoing sleeve gastrectomy (SG)...
September 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28919979/reversal-of-fibrosis-in-patients-with-nonalcoholic-steatohepatosis-after-gastric-bypass-surgery
#9
Brian M Parker, Jiang Wu, Jing You, David S Barnes, Lisa Yerian, John P Kirwan, Philip R Schauer, Daniel I Sessler
BACKGROUND: Roux-en-Y gastric bypass (RYGB) improves the pathophysiology that contributes to obesity-related nonalcoholic steatohepatitis (NASH). Whether obesity-related fibrosis improves is unclear. We hypothesized that RYGB reverses NASH and fibrosis, and indocyanine green (ICG) clearance provides a sensitive measure for detecting asymptomatic fatty liver disease. METHODS: One hundred six obese adults scheduled for RYGB had preoperative liver function assessed using standard tests and ICG clearance and core liver biopsies obtained during RYGB...
2017: BMC Obesity
https://www.readbyqxmd.com/read/28919184/clinical-significance-of-failure-to-lose-weight-10-years-after-roux-en-y-gastric-bypass
#10
Robert B Hawkins, J Hunter Mehaffey, Timothy L McMurry, Jennifer Kirby, Steven K Malin, Bruce Schirmer, Peter T Hallowell
BACKGROUND: Although Roux-en-Y gastric bypass (RYGB) induces short-term weight loss and co-morbidity amelioration, long-term data suggest that a subset of patients return to their preoperative body mass index (BMI). OBJECTIVES: To identify the clinical implications of 10-year weight loss failure after RYGB. SETTING: An academic teaching hospital. METHODS: Adults undergoing RYGB (1985-2004) were included in this study (n = 1087)...
August 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28919093/clip-closure-and-division-instead-of-stapling-for-the-last-small-gastric-bridge-between-gastric-pouch-and-remnant-stomach-in-laparoscopic-roux-en-y-gastric-bypass
#11
Adem Yuksel, Fatih Sumer, Cuneyt Kayaalp
INTRODUCTION: Here, a modification during gastric pouch forming was implemented in laparoscopic Roux-en-Y gastric bypass (LRYGB). We aimed to examine the feasibility of metallic clip closure for the remaining small stomach bridges (<1 cm) between the pouch and the remnant stomach. METHODS: During pouch creation, after the last stapler firing, the remaining small bridge was closed with clips and divided instead of using a new stapler. Metallic clips for this aim were used in 41 of 520 LRYGP between September 2010 and January 2017...
September 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28918470/assessment-of-glucose-regulation-in-pregnancy-after-gastric-bypass-surgery
#12
Christian S Göbl, Latife Bozkurt, Andrea Tura, Michael Leutner, Laura Andrei, Lukas Fahr, Peter Husslein, Wolfgang Eppel, Alexandra Kautzky-Willer
AIMS/HYPOTHESIS: Roux-en-Y gastric bypass (RYGB) surgery is characterised by glycaemic variability. Prospective studies of glucose metabolism in pregnancy after RYGB are not available, therefore this study aimed to evaluate physiological alterations in glucose metabolism in pregnancy following RYGB. METHODS: Sixty-three pregnant women (25 who underwent RYGB, 19 non-operated obese control women and 19 normal weight control women) were included. Frequently sampled 3 h OGTTs and 1 h IVGTTs were performed between 24 and 28 weeks of gestation and, in a subgroup, were repeated at 3-6 months after delivery...
September 16, 2017: Diabetologia
https://www.readbyqxmd.com/read/28917615/comment-on-patients-reasons-for-and-against-undergoing-roux-en-y-gastric-bypass-adjustable-gastric-banding-and-vertical-sleeve-gastrectomy
#13
EDITORIAL
Katherine L Applegate
No abstract text is available yet for this article.
August 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28917006/synoptic-operative-reporting-assessing-the-completeness-accuracy-reliability-and-efficiency-of-synoptic-reporting-for-roux-en-y-gastric-bypass
#14
Shannon E Stogryn, Krista Hardy, Michael J Mullan, Jason Park, Christopher Andrew, Ashley Vergis
OBJECTIVE: Synoptic reporting (SR) is one solution to improve the quality of operative reports. However, SR has not been investigated in bariatric surgery despite an identified need by bariatric surgeons. SR for RYGB was developed using quality indicators (QIs) established by a national Delphi process. The objective of this study is to assess the completeness, accuracy, reliability, and efficiency of synoptic versus narrative operative reports (NR) in Roux-en-Y gastric bypass (RYGB). METHODS: A NR and SR were completed on 104 consecutive RYGBs...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28915970/a-new-proposed-mechanism-of-action-for-gastric-bypass-surgery-air-hypothesis
#15
Hasan Celiker
Roux-en-Y gastric bypass (RYGB) surgery is one of the most effective treatments for obesity and type II diabetes. RYGB was originally believed to work by mechanically restricting caloric intake or causing macronutrient malabsorption. However, such mechanical effects play no role in the remarkable efficacy of gastric bypass. Instead, mounting evidence shows that altered neuroendocrine signaling is responsible for the weight reducing effects of RYGB. The exact mechanism of this surgical response is still a mystery...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28913642/small-volume-fast-emptying-gastric-pouch-leads-to-better-long-term-weight-loss-and-food-tolerance-after-roux-en-y-gastric-bypass
#16
Daniel Riccioppo, Marco Aurelio Santo, Manoel Rocha, Carlos Alberto Buchpiguel, Marcio Augusto Diniz, Denis Pajecki, Roberto de Cleva, Flavio Kawamoto
INTRODUCTION: Anatomical and functional influences on gastric bypass (GBP) results are often poorly evaluated and not yet fully understood. PURPOSE: The purpose of this study is to evaluate the influence of the gastric pouch volume and its emptying rate on long-term weight loss and food tolerance after GBP. MATERIALS AND METHODS: Weight loss, food tolerance, pouch volumetry (V) by three-dimensional reconstruction, and pouch emptying rate by 4 h scintigraphy were evaluated in 67 patients...
September 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28905292/effects-of-laparoscopic-roux-en-y-gastric-bypass-for-type-2-diabetes-mellitus-comparison-of-bmi-%C3%A2-30-and-%C3%A2-30%C3%A2-kg-m-2
#17
Zhigang Ke, Fan Li, Jing Chen, Yu Gao, Xunmei Zhou, Fang Sun, Chunxue Li, Baohua Liu, Qiang Li, Zhiming Zhu, Weidong Tong
BACKGROUND: Recently, many studies focused on type 2 diabetes mellitus (T2DM) patients with body mass index (BMI) < 30 kg/m(2) and suggested that those patients might benefit from Roux-en-Y gastric bypass (RYGB). However, evidence on its effectiveness to improve T2DM patients with BMI < 30 kg/m(2) is still lacking. The aim of this study is to explore whether T2DM patients with BMI < 30 kg/m(2) get similar surgical effect from RYGB compared with those patients with BMI > 30 kg/m(2)...
September 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#18
Kutay Saglam, Aydin Aktas, Ersin Gundogan, Ismail Ertugrul, Ali Tardu, Servet Karagul, Serdar Kirmizi, Fatih Sumer, Veysel Ersan, Cuneyt Kayaalp
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis...
September 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28894292/partitioning-of-adipose-lipid-metabolism-by-altered-expression-and-function-of-ppar-isoforms-after-bariatric-surgery
#19
C Jahansouz, H Xu, A V Hertzel, S Kizy, K A Steen, R Foncea, F J Serrot, N Kvalheim, G Luthra, K Ewing, D B Leslie, S Ikramuddin, D A Bernlohr
BACKGROUND: Bariatric surgery remains the most effective treatment for reducing adiposity and eliminating type 2 diabetes; however, the mechanism(s) responsible have remained elusive. Peroxisome proliferator-activated receptors (PPAR) encompass a family of nuclear hormone receptors that upon activation exert control of lipid metabolism, glucose regulation and inflammation. Their role in adipose tissue following bariatric surgery remains undefined. MATERIALS AND METHODS: Subcutaneous adipose tissue biopsies and serum were obtained and evaluated from time of surgery and on postoperative day 7 in patients randomized to Roux-en-Y gastric bypass (n=13) or matched caloric restriction (n=14), as well as patients undergoing vertical sleeve gastrectomy (n=33)...
August 14, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28894289/factors-associated-with-long-term-weight-loss-maintenance-following-bariatric-surgery-in-adolescents-with-severe-obesity
#20
J R Ryder, A C Gross, C K Fox, A M Kaizer, K D Rudser, T M Jenkins, M B Ratcliff, A S Kelly, S Kirk, R M Siegel, T H Inge
BACKGROUND/OBJECTIVES: Bariatric surgery produces robust weight loss, however, factors associated with long-term weight-loss maintenance among adolescents undergoing Roux-en-Y gastric bypass surgery are unknown. SUBJECTS/METHODS: Fifty adolescents (mean±s.d. age and body mass index (BMI)=17.1±1.7 years and 59±11 kg m(-2)) underwent Roux-en-Y gastric bypass surgery, had follow-up visits at 1 year and at a visit between 5 and 12 years following surgery (Follow-up of Adolescent Bariatric Surgery at 5 Plus years (FABS-5+) visit; mean±s...
August 14, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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