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leak in bariatric surgery

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https://www.readbyqxmd.com/read/29679337/revisional-bariatric-surgery-for-weight-regain-and-refractory-complications-in-a-single-mbsaqip-accredited-center-what-are-we-dealing-with
#1
Jeffrey Qiu, Peter W Lundberg, T Javier Birriel, Leonardo Claros, Jill Stoltzfus, Maher El Chaar
BACKGROUND: Revisional surgery is the fastest growing area in bariatric surgery, constituting 13.6% of all procedures performed as of 2015. This reflects a rising need to treat adverse sequelae of primary bariatric procedures. Despite the increase in revisions, their safety and efficacy remain controversial. The objective of this study is to review the experience of revisional bariatric surgery in our center and the relevant literature to date. METHODS: We performed an IRB-approved review of prospectively collected data from all patients undergoing revisional bariatric surgery between 2012 and 2015...
April 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29605723/risk-factors-for-gastrointestinal-leak-after-bariatric-surgery-mbsaqip-analysis
#2
Reza Fazl Alizadeh, Shiri Li, Colette Inaba, Patrick Penalosa, Marcelo W Hinojosa, Brian R Smith, Michael J Stamos, Ninh T Nguyen
BACKGROUND: Gastrointestinal leak remains one of the most dreaded complications in bariatric surgery. We aimed to evaluate risk factors and the impact of common perioperative interventions on the development of leak in patients underwent laparoscopic bariatric surgery. STUDY DESIGN: Using the 2015 database of accredited centers, data were analyzed for patients underwent laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (LRYGB). Emergent, revisional, and converted cases were excluded...
March 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29593899/feasibility-and-safety-of-bariatric-surgery-in-high-risk-patients-a-single-center-experience
#3
Yusef Moulla, Orestis Lyros, Matthias Blüher, Philipp Simon, Arne Dietrich
Introduction: Despite the feasibility and safety of bariatric procedures nowadays, high-risk patients with vast obesity and severe comorbidities demonstrate relatively high perioperative morbidity and mortality rates and, therefore, form a distinguished challenge for the bariatric surgeons. Methods: We retrospectively analyzed high-risk patients, who underwent bariatric surgery in University Hospital Leipzig between May 2012 and December 2016. High-risk patients were defined when (Bergeat et al...
2018: Journal of Obesity
https://www.readbyqxmd.com/read/29589076/-robot-assisted-vs-laparoscopic-gastric-bypass-first-experiences-with-the-davinci-system-in-bariatric-surgery
#4
J H Beckmann, H Aselmann, J H Egberts, A Bernsmeier, M Laudes, T Becker, C Schafmayer, M Ahrens
Conventional laparoscopy is the gold standard in bariatric surgery. Internationally, robot-assisted surgery is gaining in importance. Up to now there are only few reports from Germany on the use of the system in bariatric surgery. Since January 2017 we have been performing robot-assisted gastric bypass surgery. It remains unclear whether the use of the robotic system has advantages over the well-established laparoscopic technique. Within a period from January to early August 2017 a total of 53 gastric bypass operations were performed...
March 27, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29567060/laparoscopic-sleeve-gastrectomy-as-a-viable-option-for-an-ambulatory-surgical-procedure-our-52-month-experience
#5
Sepehr Lalezari, Matthew C Musielak, Lisa A Broun, Trace W Curry
BACKGROUND: We present our experience with same-day discharge (without an overnight stay) after laparoscopic sleeve gastrectomy (SG) in 821 consecutive patients from 2011 to 2015. This is the largest series published to date of patients undergoing ambulatory surgery for such a procedure. OBJECTIVES: To review our outcomes from ambulatory SG over 52 months to determine if SG can be safely performed in the ambulatory setting. SETTING: Ambulatory surgery center...
February 17, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29541922/the-15-cm-roux-limb-a-technical-misadventure
#6
Wesley F Kim, Thomas Sonnanstine
BACKGROUND: Despite effectively treating obesity and its comorbidities, only a fraction of the growing obese population is evaluated for bariatric surgery. Aside from barriers including resources and social support, patients report personal experience with friends and relatives suffering poor outcomes after bariatric surgery. Rates of mortality, leaks, and strictures have decreased over the past 20 years, but few instances of gross surgeon error have been reported in the literature. Our objective is to report and demonstrate the revision of a critically shortened Roux limb in a patient with chronic nausea and dysphagia found to have a 15-cm Roux limb and briefly discuss its implications...
March 14, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29519658/is-laparoscopic-sleeve-gastrectomy-safer-than-laparoscopic-gastric-bypass-a-comparison-of-30-day-complications-using-the-mbsaqip-data-registry
#7
Sandhya B Kumar, Barbara C Hamilton, Stephanie G Wood, Stanley J Rogers, Jonathan T Carter, Matthew Y Lin
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become popular due to its technical ease and excellent short-term results. Understanding the risk profile of LSG compared with the gold standard laparoscopic Roux-en-Y gastric bypass (LRYGB) is critical for patient selection. OBJECTIVES: To use traditional regression techniques and random forest classification algorithms to compare LSG with LRYGB using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Data Registry...
March 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29516397/efficacy-of-postoperative-upper-gastrointestinal-series-ugi-and-computed-tomography-ct-scan-in-bariatric-surgery-a-meta-analysis-on-7516-patients
#8
Mario Musella, Valeria Cantoni, Roberta Green, Wanda Acampa, Nunzio Velotti, Paola Maietta, Alberto Cuocolo
BACKGROUND: To demonstrate the lack of utility and efficacy of routine early postoperative upper gastrointestinal study (UGI) in obese patients undergoing bariatric surgery and to show the higher efficacy of CT scan in cases of clinical suspicion of a leakage, a meta-analysis was performed. MATERIALS AND METHODS: A literature search including articles published in last 18 years was performed. For both UGI and CT scan, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated...
March 7, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29508273/comparison-between-stable-line-reinforcement-by-barbed-suture-and-non-reinforcement-in-sleeve-gastrectomy-a-randomized-prospective-controlled-study
#9
Mohamed Hany, Mohammed Ibrahim
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is now a popular bariatric procedure worldwide with rising prevalence over the last decade. Staple line leak and bleeding are the most dangerous complications of LSG. Staple line reinforcement (SLR) by oversewing the staple line was suggested to reduce the incidence of leak and bleeding. We designed a randomized controlled prospective study to investigate the value of SLR by invaginating the whole staple line using unidirectional absorbable 3/0 V-Loc 180 sutures (Covidien, Mansfield, MA, USA) to no SLR in LSG...
March 5, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29503096/which-postoperative-complications-matter-most-after-bariatric-surgery-prioritizing-quality-improvement-efforts-to-improve-national-outcomes
#10
Christopher R Daigle, Stacy A Brethauer, Chao Tu, Anthony T Petrick, John M Morton, Philip R Schauer, Ali Aminian
BACKGROUND: National quality programs have been implemented to decrease the burden of adverse events on key outcomes in bariatric surgery. However, it is not well understood which complications have the most impact on patient health. OBJECTIVE: To quantify the impact of specific bariatric surgery complications on key clinical outcomes. SETTING: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29500672/preoperative-detection-of-sarcopenic-obesity-helps-to-predict-the-occurrence-of-gastric-leak-after-sleeve-gastrectomy
#11
Martin Gaillard, Hadrien Tranchart, Sophie Maitre, Gabriel Perlemuter, Panagiotis Lainas, Ibrahim Dagher
BACKGROUND: Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery. OBJECTIVES: The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG...
March 2, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#12
Gautam Sharma, Zubaidah Nor Hanipah, Ali Aminian, Suriya Punchai, Emre Bucak, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29428692/routine-contrast-imaging-after-bariatric-surgery-and-the-effect-on-hospital-length-of-stay
#13
Uzma Rahman, Salvatore Docimo, Aurora D Pryor, Andrew Bates, Nabeel R Obeid, Konstantinos Spaniolas
BACKGROUND: Although multiple studies demonstrate that routine postoperative contrast studies have a low yield in diagnosing patients with early gastrointestinal (GI) leak after bariatric surgery, the practice pattern is unknown. Additionally, routine imaging may hinder procedural pathways that lead to accelerated postoperative discharge. OBJECTIVES: To report on the nationwide use of routine upper GI studies (UGI) and evaluate the effect on hospital resource utilization...
April 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29428690/enteral-stents-in-the-management-of-post-bariatric-surgery-leaks
#14
Hany Shehab
A post-bariatric surgery leak is a rare but grave condition and remains every bariatric surgeon's nightmare. Endoscopic therapy with the insertion of self-expandable stents provides an effective minimally invasive approach for the management of leaks. Self-expandable stents, however, are still hampered by their tendency for migration and are not always well tolerated. Recently, double-pigtail stents have been proposed as an alternative endoscopic therapeutic modality. Both types of stents have been shown to be very effective in the management of leaks; however, most studies have pooled gastrointestinal leaks due to different etiologies together...
December 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29428689/impact-of-age-on-risk-of-complications-after-gastric-bypass-a-cohort-study-from-the-scandinavian-obesity-surgery-registry-soreg
#15
Peter Gerber, Claes Anderin, Eva Szabo, Ingmar Näslund, Anders Thorell
BACKGROUND: An increasing number of older patients undergo bariatric surgery. OBJECTIVE: To define the risk for complications and mortality in relation to age after gastric bypass. SETTING: A national registry-based study. METHODS: Patients (n = 47,660) undergoing gastric bypass between May 2007 and October 2016 and registered in the Scandinavian Obesity Register were included. Risk between age groups was compared by multivariate analysis...
January 4, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29423166/endoscopic-use-of-epifix-dehydrated-human-amnion-chorion-membrane-dhacm-allograft-in-patients-with-gastric-leak-following-sleeve-gastrectomy
#16
D O Nicholas Sousa, D O Rahil Dharia, D O Shilpin Mehta, D O Keith Marshall, D O David Siegel
Leak following laparoscopic sleeve gastrectomy is one of the most feared complications and its management can be difficult and frustrating for patients and physicians involved. Using multimodality approach and having variable options to plan management for patients presenting with leak following bariatric surgery can be advantageous for physicians. The use of endoscopic injection of EpiFix-dehydrated Human Amnion/Chorion Membrane (dHACM) allograft can be a novel adjunct in facilitating healing of the leak site by iatrogenic introduction of tissue growth factors, cytokines and building connective tissue matrix...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29417487/perioperative-outcomes-of-laparoscopic-and-robotic-revisional-bariatric-surgery-in-a-complex-patient-population
#17
Katherine D Gray, Maureen D Moore, Adham Elmously, Omar Bellorin, Rasa Zarnegar, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: Utilization of the robotic platform has become more common in bariatric applications. We aim to show that robotic revisional bariatric surgery (RRBS) can be safely performed in a complex patient population with perioperative outcomes equivalent to laparoscopic revisional bariatric surgery (LRBS). METHODS: Retrospective review was conducted of adult patients undergoing laparoscopic revisional bariatric surgery (LRBS) or robotic revisional bariatric surgery (RRBS) at our institution from September 2007 to December 2016...
February 7, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29398898/stomach-intestinal-pylorus-sparing-surgery-for-morbid-obesity
#18
Bo T Neichoy, Bleu Schniederjan, Daniel R Cottam, Amit K Surve, Hinali M Zaveri, Austin Cottam, Samuel Cottam
Background and Objective: The Roux-en-Y duodenal switch (RYDS) is one of the most efficient forms of bariatric surgery. However, diarrhea, malnutrition, ulcers, and internal hernias have hampered its widespread adoption. The stomach intestinal pylorus-sparing (SIPS) procedure was developed to alleviate these sequelae while retaining the same weight loss as the RYDS. In this study, we report our midterm experience with this novel technique. Methods: Retrospective analysis was performed on data from 225 patients who underwent a primary SIPS procedure by 2 surgeons at a single center from October 2013 through December 2016...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29398036/what-matters-after-sleeve-gastrectomy-patient-characteristics-or-surgical-technique
#19
Vikrom K Dhar, Dennis J Hanseman, Brad M Watkins, Ian M Paquette, Shimul A Shah, Jonathan R Thompson
BACKGROUND: The impact of operative technique on outcomes in laparoscopic sleeve gastrectomy has been explored previously; however, the relative importance of patient characteristics remains unknown. Our aim was to characterize national variability in operative technique for laparoscopic sleeve gastrectomy and determine whether patient-specific factors are more critical to predicting outcomes. METHODS: We queried the database of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for laparoscopic sleeve gastrostomies performed in 2015 (n = 88,845)...
March 2018: Surgery
https://www.readbyqxmd.com/read/29344787/a-novel-fully-covered-double-bump-stent-for-staple-line-leaks-after-bariatric-surgery-a-retrospective-analysis
#20
Thomas C C Boerlage, Gerardus P M Houben, Marcel J M Groenen, Klaas van der Linde, Arnold W J M van de Laar, Marloes Emous, Paul Fockens, Rogier P Voermans
BACKGROUND: Staple line leakage after bariatric surgery can be treated by endoscopic placement of a self-expandable stent. The success rate of stent placement is generally high, but migration is a frequent adverse event that hampers successful treatment. The Niti-S Beta stent is a fully covered double-bump stent that was specifically designed to prevent migration. This study aimed to evaluate the effectiveness and adverse event rate of the Niti-S Beta stent. METHODS: A retrospective study was performed in three high-volume bariatric centers...
January 17, 2018: Surgical Endoscopy
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