Optimizing the Benefits of Roux-en-Y Gastric Bypass with Preoperative Optimization of Diabetes Mellitus: Is There an Ideal Glycosylated Hemoglobin Level?

Roux-en-Y gastric bypass (RYGB) affords a long-term, durable approach to the management of diabetes mellitus (DM) in morbidly obese patients. Nevertheless, patients with DM are at an increased risk for 30-day wound events and additional morbidity and mortality compared with patients without DM. The purpose of our study was to determine if there is a preoperative glycosylated hemoglobin (HgA1c) target level that can be used as a surrogate for optimization of DM in diabetic patients before RYGB.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Bariatric and foregut Source Type: research

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We report two cases of young women with diabetes who underwent bariatric surgery and had complications resulting from extensive inflammation and necrosis of adipose tissue. The first patient was diagnosed with omental infarction, which is a type of fat necrosis that is rarely associated with obesity and bariatric surgery. The second patient had an intraoperative finding of mesenteric panniculitis, which resulted in an intra-operative change in the choice of bariatric surgery to do a sleeve gastrectomy instead of a gastric bypass. Surgeons who perform surgery on bariatric patients must be aware of complications related to e...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
AbstractBackgroundWhile laparoscopic sleeve gastrectomy (LSG) continues to be the most commonly performed bariatric operation, several variables influence surgeons ’ practice patterns and patients’ decision-making in the type of bariatric procedure to perform. The aim of this study was to evaluate patient factors that influence the decision between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus LSG.MethodsThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried for patients undergoing LSG and LRYGB between 2015 and 2017. Univariate analysis and multi...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
CONCLUSION: gastric bypass is an effective method for the resolution of comorbidities and reduction of cardiovascular risk, but it is very important to monitor as many patients as possible, and to report on the long-term results, to determine the real effectiveness of these procedures. PMID: 32686438 [PubMed - as supplied by publisher]
Source: Nutricion Hospitalaria - Category: Nutrition Authors: Tags: Nutr Hosp Source Type: research
no LK Abstract Purpose To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique. Methods Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were ≥ 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value ≤0.05it was considered significant. Results Ten (90.9%) patients with dyslipidemia were cured (p
Source: Acta Cirurgica Brasileira - Category: Surgery Authors: Tags: Acta Cir Bras Source Type: research
Abstract Obesity has become a global health problem. Lifestyle modification and medical treatment only appear to yield short-term weight loss. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it sustains weight reduction and results in the remission of obesity-associated comorbidities for obese individuals. However, patients who undergo this surgery may develop hypoglycemia. To date, the diagnosis is challenging and the prevalence of post-RYGB hypoglycemia (PRH) is unclear. RYGB alters the anatomy of the upper gastrointestinal tract and has a combined effect of caloric intake restrictio...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
AbstractPurpose of ReviewKnowledge regarding postoperative outcomes after bariatric and metabolic surgery continues to evolve. This review highlights key findings in outcomes research over the last 5  years related to weight loss, remission of obesity-related disease, reflux, revisional surgery, robotic-assisted surgical platforms, and adolescent populations.Recent FindingsSleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) produce similar weight loss patterns at 5  years, while duodenal switch (BPD/DS) and related procedures are associated with maximal weight loss overall and optimal resolution of obesit...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research
Obesity is a well-known risk factor for the development of type 2 diabetes mellitus (T2D). The efficacy of bariatric surgery in reducing weight with resulting improvement in T2D has been reliably demonstrated.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
Conclusions: RYGB is effective as a conversion procedure after a previous restrictive surgery, obtaining a significant reduction in weight and BMI. It has an acceptable morbidity rate and is more effective after an AGB.Obes Facts 2020;13:367 –374
Source: Obesity Facts - Category: Eating Disorders & Weight Management Source Type: research
Objective: We sought to compare the short and long-term outcomes of MBS in adolescents vs. adults who have undergone a Roux-en-Y gastric bypass (RYGB) or Sleeve gastrectomy (SG).Design: Retrospective cohort study.Setting: Single tertiary care academic referral center.Participants: One hundred fifty adolescent (≤ 21-years) and adult (>21-years) subjects with severe obesity between 15 and 70 years of age who underwent RYGB or SG.Outcomes: Metabolic parameters, weight and height measures were obtained pre-and post-surgery (at 3 and 6 months, and then annually for 4 years).Results: Median pre-surgical body mass index (BM...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
ConclusionsMild-to-moderate PPHG is a frequent complication after bariatric surgery and results in smaller weight loss after 2  years. Age, baseline BMI, and an earlier glucose peak during OGTT predict PPHG after bariatric surgery.
Source: Obesity Surgery - Category: Surgery Source Type: research
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