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leak in bariatric surgery

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https://www.readbyqxmd.com/read/29915974/managing-a-positive-air-leak-test-during-a-gastrojejunostomy-revision
#1
Dvir Froylich, Matthew Davis, Gautam Sharma, Tammy Fouse, Philip Schauer, Stacy Brethauer
BACKGROUND: Gastrojejunostomy revision after gastric bypass surgery is a challenging procedure that requires advanced skills. The air-leak test was performed to identify gastrojejunostomy leaks. Omental patch seal technique is a well-known treatment of perforated gastrojejunostomy ulcers (Surg Obes Relat Dis 4:423-8, 2012; Surg Endosc 2:384-9, 2013; Surg Endosc 11:2110, 2007). METHODS: We present a case of a 40-year-old female, who underwent laparoscopic gastric bypass 6 years prior and subsequently developed marginal ulcer, resulting in chronic gastrojejunostomy stricture...
June 18, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29907941/the-clinical-outcome-of-postoperative-invasive-fungal-infections-complicating-laparoscopic-sleeve-gastrectomy
#2
Yoav Bichovsky, Leonid Koyfman, Michael Friger, Boris Kirshtein, Abraham Borer, Gilbert Sebbag, Dmitry Frank, Amit Frenkel, Jochanan G Peiser, Moti Klein, Evgeni Brotfain
PURPOSE: Peritonitis is a major complication of bariatric surgery due to direct damage to the natural barriers to infection. Most such secondary peritoneal infections are caused by Gram-negative microorganisms; however, under certain conditions, Candida species can infect the peritoneal cavity following bariatric surgery. MATERIALS AND METHODS: We retrospectively analyzed the clinical and microbiological data of morbidly obese patients who suffered infectious complications following laparoscopic sleeve gastrectomy (LSG) at the Soroka Medical Center between January 2010 and June 2015...
June 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29875989/extensive-thrombus-and-brain-microabscesses-after-sleeve-gastrectomy
#3
Grace Faith Chao, Sameer Hirji, Scott Alan Shikora
Sleeve gastrectomy is a relatively newer bariatric surgical procedure and has become the most common of all bariatric surgeries performed. Complication rates reported with sleeve gastrectomies are relatively low and are generally due to staple line leaks, hemorrhage, or sleeve stricture. Portal vein thrombosis is an uncommon but potentially dangerous complication. We present a case of a 21-year-old woman who developed thrombosis of the portal, splenic, and right common iliac veins that then resulted in multifocal brain abscesses from presumed Fusobacterium septic emboli following an uncomplicated laparoscopic sleeve gastrectomy...
March 2018: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29868637/endoscopic-biodegradable-stents-as-a-rescue-treatment-in-the-management-of-post-bariatric-surgery-leaks-a-case-series
#4
Abed Al Lehibi, Areej Al Balkhi, Abdullah Al Mtawa, Nawaf Al Otaibi
Background and aims:  Postoperative leak is one of the most feared complications after bariatric surgery. Endoscopic stenting is used to manage leaks by decreasing the gastrointestinal intraluminal pressure. The main advantage of endoscopic management is providing healing while still allowing for oral nutrition. However, limited literature exists on whether biodegradable stents can be used to control leaks when conventional metallic stents fail. Methods:  Our series consists of four patients who were found to have a leak as a complication of bariatric surgery...
June 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29804282/revisional-but-not-conversional-gastric-bypass-surgery-increases-the-risk-of-leaks-review-of-176-redo-out-of-932-consecutive-cases
#5
Marine Benois, Lionel Sebastianelli, Adeline Morisot, Imed Ben Amor, Jean Gugenheim, Laurent Bailly, Antonio Iannelli
INTRODUCTION: Nowadays, surgeons are dealing more and more with patients experiencing failure of a previous bariatric procedure after the worldwide exponential increase of bariatric surgery. Only a few and contradictory studies investigated both outcomes and complications risk factors in this subset population of bariatric patients. We aimed to study a homogeneous population of patients undergoing redo bariatric surgery (REDO-BS) resulting in bypass anatomy to evaluate early postoperative outcomes and identify risk factors of postoperative complications and mortality...
May 26, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29703506/safety-and-short-term-outcomes-of-laparoscopic-sleeve-gastrectomy-for-patients-over-65-years-old-with-severe-obesity
#6
Panagiotis Lainas, Carmelisa Dammaro, Martin Gaillard, Gianfranco Donatelli, Hadrien Tranchart, Ibrahim Dagher
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted, stand-alone bariatric operation. Data on elderly patients undergoing LSG are scarce. OBJECTIVES: The aim of this study was to demonstrate that LSG is safe and effective for patients>65 years old with severe obesity. SETTING: Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, Paris-Saclay University, France. METHODS: Prospectively collected data from consecutive patients undergoing LSG were retrospectively analyzed...
March 8, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29686922/endolumenal-vacuum-therapy-and-fistulojejunostomy-in-the-management-of-sleeve-gastrectomy-staple-line-leaks
#7
Kyle Szymanski, Estrellita Ontiveros, James S Burdick, Daniel Davis, Steven G Leeds
Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery performed for morbid obesity. Leaks of the vertical staple line can occur in up to 7% of cases and are difficult to manage. Endolumenal vacuum (EVAC) therapy and fistulojejunostomy (FJ) have separate documented uses to heal these complicated leaks. We aim to show the benefit of using EVAC with FJ in the treatment of LSG staple line leaks. The patient presented with an LSG chronic leak. EVAC therapy was initiated but failed to close the fistula after 101 days...
2018: Case Reports in Surgery
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
#8
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-mbasqip-analysis
#9
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 who underwent laparoscopic bariatric surgery. STUDY DESIGN: Using the 2015 database of accredited centers, data were analyzed for patients who underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass (LRYGB). Emergent, revisional, and converted cases were excluded...
March 30, 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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