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leak in bariatric surgery

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https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#1
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
#2
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...
January 3, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29333067/complications-of-staple-line-and-anastomoses-following-laparoscopic-bariatric-surgery
#10
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
#11
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
#12
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
#13
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
#14
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/29197192/laparoscopic-gastric-plication-for-the-treatment-of-morbid-obesity-by-using-real-time-imaging-of-the-stomach-pouch
#15
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/29181746/severe-dehiscence-of-gastrojejunal-anastomosis-after-gastric-bypass-its-cure-by-using-partially-covered-stent-and-avoiding-migration
#16
Helga C A W Alhinho, Flávio C Ferreira, Rodrigo C L Medeiros, Álvaro A B Ferraz, Josemberg M Campos
BACKGROUND: Gastric leak is a severe complication of gastric bypass that is associated with significant morbidity and mortality. Anastomosis dehiscence usually occurs at gastrojejunal anastomosis and can appear simultaneously with gastric leak, for which treatment can be a challenge. Fistula may have several clinical impacts, depending on patient-related factors, fistula characteristics, onset time, and therapy proposal. Abdominal toilet, drainage, gastrostomy, and revisional surgery constitute the traditional approaches to dehiscence and fistula closure, with variable results...
November 27, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29159552/the-effect-of-helicobacter-pylori-on-postoperative-outcomes-in-patients-undergoing-bariatric-surgery-a-systematic-review-and-meta-analysis
#17
REVIEW
Valentin Mocanu, Jerry T Dang, Noah Switzer, Daniel Skubleny, Xinzhe Shi, Chris de Gara, Daniel W Birch, Shahzeer Karmali
Helicobacter pylori (HP) occurs in 50% of people worldwide with higher rates reported in the bariatric population. HP has been associated with adverse outcomes following bariatric surgery; however, its true impact has not yet been defined. We aimed to systematically review the effect of HP on bariatric surgery outcomes. A comprehensive literature review was conducted yielding seven studies with 255,435 patients. Meta-analysis found comparable rates of bleeding, leak, hospital length of stay, and weight loss between HP-positive and HP-negative patients...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#18
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/29124550/gastrectomy-with-extended-lymphadenectomy-a-north-american-perspective
#19
Alexandre Gosselin-Tardif, Jessica Lie, Ioana Nicolau, Juan Carlos Molina, Jonathan Cools-Lartigue, Liane Feldman, Jonathan Spicer, Carmen Mueller, Lorenzo Ferri
PURPOSE: Despite evidence of oncologic benefits from extended (D2) lymphadenectomy in gastric cancer from many East Asian studies, there is persistent debate over its use in the West, mainly due to perceived high rates of morbidity and mortality. This study evaluates the safety and efficacy of D2 dissection in a high-volume North American center. METHODS: A prospectively entered database of all patients undergoing gastrectomy for cancer at a North American referral center from 2005 to 2016 was reviewed...
November 9, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
#20
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
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