Carotid intima-media thickness and ınsulin resistance changes in patients who underwent sleeve gastrectomy: A prospective study
Conclusions: Bariatric surgery may provide some additional advantages for the management of cardiovascular risks in obese patients. However, it should be kept in mind that the most important components of fight against obesity are appropriate diet and exercise programs.
Vertical sleeve gastrectomy (VSG) has been associated with gastroesophageal reflux (GER) symptoms and, in adults, with a development of Barrett ’s esophagus (BE). Adults with Barrett’s esophagus identified at baseline prior to bariatric operation are generally advised against VSG operations. The role of preoperative esophagogastroduodenoscopy (EGD) in adolescents preparing for bariatric surgery is not clearly defined. The goal of this s tudy was to report the frequency of abnormalities identified on EGD performed at baseline in adolescents undergoing VSG for severe obesity.
ConclusionsIntraluminal indocyanine green is an alternative for intraoperative detection of staple line integrity during bariatric surgical procedures with comparable specificity to intraoperative gastroscopy.
The global obesity epidemic over the past decade has led to the development of several surgical therapeutic options for severe obesity, defined as a body mass index (BMI) of 40 kg/m2.1 Patients with BMI of 35 to 39.9 kg/m2 with an obesity-related comorbidity such as diabetes or hypertension and patients with a BMI of>30 kg/m2 and metabolic syndrome, or difficult-to-control diabetes, are also suitable for bariatric surgical procedures.1 Bariatric surgical procedures can be classified into restrictive procedures such as sleeve gastrectomy, malabsorptive procedures such as jejunoileal bypass and biliopancreatic diversion, ...
ConclusionsThis is the first report of cognitive improvements following VSG and the first direct comparison of cognitive improvements following RYGB and VSG. Short-term improvements in specific domains of cognitive function are observed at the beginning of the active weight loss phase following bariatric surgery that persisted to 3 months. The anatomical distinction between the two surgeries and resulting differential metabolic profiles may be responsible for the improvements in attention observed following RYGB but not following VSG.
ConclusionsForegut pathology is common in bariatric patients with subjective symptoms of GERD. Implementing a comprehensive protocol to objectively assess these patients leads to a significant clinical impact on which procedure these patients ultimately undergo.
This study included patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). The primary outcome of interest was incisional SSI occurring within 30 days. Surgeries performed in 2015 were used in a derivation cohort and the predictive tool was validated against the 2016 cohort. A forward selection algorithm was used to build a logistic regression model predicting probability of SSI.ResultsA total of 274,187 patients were included with 71.7% being LSG and 28.3% LRYGB. 0.7% of patients had a SSI in which 71.0% had an incisional SSI, and 29.9% had an organ/spa...
We report the case of a patient presenting with sepsis 2 weeks after surgery. A subphrenic collection and a leak were found on CT. Despite medical treatment, the patient did not show clinical improvement. Hence, we considered a transgastric endosonographic-guided drainage of the collection using an electrocautery-enhanced lumen-apposing metal stent (LAM S). The procedure underwent uneventfully, and the patient status improved rapidly. Two weeks later, the stent was withdrawn. A follow-up endoscopy 6 weeks later showed closure of the gastric wall defect.
AbstractObjectiveTo evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity.MethodsPatients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery.ResultsSeventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) ...
AbstractPurpose of reviewBariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.FindingsRecent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett ’s esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The int...
ConclusionsCholelithiasis after SG and OAGB was higher than GCP. %EWL was rapid and higher in OAGB and SG contributing to the higher rate of symptomatic cholelithiasis and could be predictive for post-bariatric cholelithiasis. A 6-month use of UDCA is an effective prophylaxis decreasing gallstone formation after bariatric surgery at short-term follow-up.
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