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Endoscopy Bariatric Surgery

Mohamad A Minhem, Bassem Y Safadi, Hani Tamim, Aurelie Mailhac, Ramzi S Alami
BACKGROUND: Intraoperative endoscopy (IOE) has been proposed to decrease serious complications following bariatric surgeries such as leaks, bleeding, and stenosis. Such complications can lead to sepsis and eventually can be fatal. We aim to compare major postoperative complications in patients with and without IOE. METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program database years 2011 till 2016 were used to identify laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) patients...
January 31, 2019: Surgical Endoscopy
Radwan Kassir, Rani Kassir, Bénédicte Deparseval, Sarah Bekkar, Chloé Serayssol, Olivier Favre, Pierre-Philippe Garnier
There is no consensus when it comes to the necessity of an oeso-gastroduodenal fibroscopy (OGDF) before and after bariatric surgery. Many reports expressed the preoccupations about a gastroesophagal reflux disease (an acute risk of Barrett's esophagus) and its consequences after a sleeve gastrectomy (SG) and the risk of leaving a premalignant lesion in an excluded stomach after a Roux-en-Y gastric bypass. The International Federation for the Surgery of Obesity and Metabolic Disorders recommends a surveillance endoscopy, routinely after a SG...
January 16, 2019: World Journal of Gastrointestinal Endoscopy
Angelo Iossa, Gianfranco Silecchia
PURPOSE: The aim of the present paper is to report the results of a single institution series of hiatal hernia repair (HHR) with augmented mesh hiatoplasty focusing on safety and efficacy profile of Bio-A absorbable synthetic mesh. MATERIALS AND METHODS: A retrospective evaluation of prospectively maintained database showed 120 consecutive patients submitted to HHR reinforced with bio-absorbable synthetic mesh. The study populations included two groups: (A) 92 obese patients-reinforced hiatoplasty concurrent with bariatric procedure; (B) 28 non-obese patients-reinforced hiatoplasty concurrent with antireflux surgery...
January 23, 2019: Surgical Endoscopy
Lionel Sebastianelli, Marine Benois, Geoffroy Vanbiervliet, Laurent Bailly, Maud Robert, Nicolas Turrin, Emmanuel Gizard, Mirto Foletto, Marco Bisello, Alice Albanese, Antonella Santonicola, Paola Iovino, Thierry Piche, Luigi Angrisani, Laurent Turchi, Luigi Schiavo, Antonio Iannelli
BACKGROUND: Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG). AIM: The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5 years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy. PATIENTS AND METHODS: Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study...
January 21, 2019: Obesity Surgery
Eduardo Espinet Coll, Gontrand López-Nava Breviere, Javier Nebreda Durán, Carlos Marra-López Valenciano, Román Turró Arau, José Miguel Esteban López-Jamar, Miguel Muñoz-Navas
During the last years we have been witnessing a significant increase in the number and type of bariatric endoscopic techniques: we have different types of balloons, suture systems, injection of substances and malabsorptive prosthesis, etc. Also, some endoscopic revisional procedures for patients with weight regain after bariatric surgery have been incorporated. This makes it necessary to protocolize, position and regularize all these techniques, through a consensus that allows their clinical application with the maximum medical rigor and scientific evidence available...
January 18, 2019: Revista Española de Enfermedades Digestivas
Florin Turcu, Cristian Balahura, Ionut Doras, Alina Constantin, Catalin Copaescu
Background: Owing to the increased use of laparoscopic sleeve gastrectomy (LSG) as a metabolic procedure, a rarely associated complication, the Symptomatic Stenosis (SS) will be more often encounter. The objective of this study is to establish a safe and effective management of SS after LSG. Methods: We have analyzed all the patients with SS after LSG treated in Ponderas Academic Hospital from 2011 to 2018. The information was retrospectively extracted from a prospectively maintained database. Laparoscopy and/or endoscopy were used to treat the organic or functional SS...
November 2018: Chirurgia
Imed Ben Amor, Tarek Debs, Giorgio Dalmonte, Radwan Kassir, Patrick Baqué, Niccolo Petrucciani, Jean Gugenheim
BACKGROUND: Laparoscopic sleeve gastrectomy represents the most performed bariatric procedure in France. Staple line leak is the major short-term complication of the procedure. Patients with persistent fistula after sleeve gastrectomy, after failure of endoscopic and radiological treatment, are candidates for salvage surgery. Laparoscopic fistulo-jejunostomy (LRYFJ) represents a surgical option to treat persistent fistula post sleeve. METHODS: The case of a 46-year-old woman, with persistent fistula after sleeve gastrectomy, undergoing laparoscopic fistula-jejunostomy is presented...
December 13, 2018: Obesity Surgery
Alberto Baptista, Diogo Turiani Hourneaux De Moura, Pichamol Jirapinyo, Eduardo Guimarães Hourneaux De Moura, Andres Gelrud, Michel Kahaleh, Alberto Salinas, Luis Carlos Sabagh, Andrés O Jaramillo, Víctor Zambrano Rincones, Raul Doval, Jack William Bandel, Christopher C Thompson
INTRODUCTION: Endoscopy has evolved to become first-line therapy for the treatment of post-bariatric leaks; however, many sessions are often required with variable success rates. Due to these limitations, the use of the cardiac septal defect occluder (CSDO) has recently been reported in this population. METHODS: This is a multicenter retrospective series in patients with post-bariatric surgical leaks who underwent treatment with CSDO placement. Data were collected including type of surgery, previous treatment details, fistula dimensions, success rate, and adverse events...
December 6, 2018: Gastrointestinal Endoscopy
S Elens, T Roger, M Elens, J Rommens, A Sarafidis, E Capelluto, C Delcour
OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of left gastric artery (LGA) embolization for the treatment of overweight patients who weren't candidates for bariatric surgery. MATERIALS AND METHODS: We retrospectively collected data of 16 patients who underwent a selective embolization of the LGA. The mean body mass index (BMI) before intervention was 28.9 kg/m2  ± 2.5, and therefore, patients were not candidates for bariatric surgery in Belgium...
November 28, 2018: Cardiovascular and Interventional Radiology
Christer D Johansen, Jan Norum, Bernt E Engebretsen, Uwe Agledahl
Bariatric surgery is an effective approach for weight loss and short-term improvement in metabolic disorders. Stenosis is a common complication of gastric banding. Balloon dilatation or gastrotomy has been employed in this setting. Few studies have indicated endoscopic removal of the band a feasible procedure. We present a 60-year-old female who underwent gastric banding in 1985 and suffered from late stenosis and malnutrition. Endoscopy revealed a severe stenosis. A two-step procedure was performed. Initially a coated stent was placed into the stenosis to achieve pressure necrosis...
November 2018: Journal of Surgical Case Reports
Diogo T H de Moura, Amit H Sachdev, Christopher C Thompson
PURPOSE OF REVIEW: Gastrointestinal transmural defects are defined as total rupture of the gastrointestinal wall and can be divided into three main categories: perforations, leaks, and fistulas. Due to an increase in the number of therapeutic endoscopic procedures including full-thickness resections and the increase incidence of complications related to bariatric surgeries, there has been an increase in the number of transmural defects seen in clinical practice and the number of non-invasive endoscopic treatment procedures used to treat these defects...
December 2018: Current Treatment Options in Gastroenterology
G Kourounis, R Pearson, D McArthur, S Gibson
Bariatric surgery is an established intervention providing significant health benefits to patients with obesity. As a result, the National Institute for Health and Care Excellence now recommends bariatric surgery for those that fulfil the eligibility criteria, while emphasising the need for multidisciplinary care before and after surgery. The UK National Bariatric Surgery Registry shows gastric band procedures to be the second most common bariatric procedure performed in the UK. Gastric band erosion is a known potential complication treated primarily by laparoscopic removal of band and repair of stomach...
October 29, 2018: Annals of the Royal College of Surgeons of England
Lionel El Khoury, Rosa Benvenga, Rodolfo Romero, Regis Cohen, Joel Roussel, Jean-Marc Catheline
INTRODUCTION: Sleeve gastrectomy (SG) has become one of the most dramatically increasing bariatric procedures worldwide due to its excellent results and impact on the obesity pandemic. Morbid obesity is known to increase the risk of esophageal adenocarcinoma. However, the evolution of gastroesophageal reflux disease (GERD) along with Barrett's esophagus (BE) after SG is of concern since there is little data available. We present a case of esophageal adenocarcinoma after SG with known intestinal metaplasia on preoperative gastroscopy...
2018: International Journal of Surgery Case Reports
Bassem Abou Hussein, Ali Khammas, Mariam Shokr, Maiyasa Majid, Mariam Sandal, Sameer Al Awadhi, Alya Al Mazrouei, Faisal Badri
Introduction  The routine use of preoperative endoscopy for patients undergoing bariatric surgery is controversial. Although many surgeons find it unnecessary, others still consider it a mandatory tool in preoperative assessment. Patients and methods  We reviewed the medical records of all patients who had undergone preoperative endoscopy before bariatric surgery in Rashid Hospital between January 2013 and June 2016. The patients were divided into three groups: Group 0 included patients with normal endoscopy; Group 1 included patients with abnormalities that did not affect the timing or type of procedure; Group 2 included patients with abnormalities that had a direct impact on the procedure...
October 2018: Endoscopy International Open
Pichamol Jirapinyo, Christopher C Thompson
Bariatric endoscopy is an emerging subspecialty for gastroenterologists encompassing a broad array of procedures including primary endoscopic bariatric and metabolic therapies and the treatment of complications of bariatric surgery. In addition, comprehensive understanding of lifestyle intervention and pharmacotherapy are essential to successful outcomes. This review summarizes goals and steps of training for this emerging field.
September 2018: Clinical Endoscopy
Christine Stroh, Uwe Will, Frank Meyer, Thomas Manger
The 2011 World Health Summit reported the epidemics of diabetes mellitus and morbid obesity. In Germany, 62.7% of the population have a BMI above 25 kg/m² and 21.9% above 30 kg/m². 10.5 patients per 100,000 inhabitants were treated with metabolic surgery, whereas in France 86.0 and in Sweden 114.8 patients per 100,000 inhabitants were given surgery. The development of endoscopic methods leads to the opportunity to bridge patients with a high risk profile before operation. Endoscopy is an excellent procedure with few complications...
October 5, 2018: Zentralblatt Für Chirurgie
Benjamin Clapp, Joshua Hahn, Christopher Dodoo, Angela Guerra, Elizabeth de la Rosa, Alan Tyroch
BACKGROUND: Marginal ulcer (MU) formation is a known problem after gastric bypass. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database contains data from all US and Canadian Centers of Excellence including complication rates. We hypothesized that the short-term rate of ulceration is low. METHODS: We queried the MBSAQIP database for the year 2015. We searched patients with primary gastric bypass who developed MU. We then compared preoperative, operative, and postoperative characteristics with patients who did not develop MU...
September 24, 2018: Surgical Endoscopy
Chin Hong Lim, Phong Ching Lee, Eugene Lim, Jeremy Tan, Weng Hoong Chan, Hong Chang Tan, Sonali Ganguly, Kwang Wei Tham, Alvin Eng
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become the preferred bariatric procedure in many countries. However, there is one shortcoming of LSG in the long-term follow-up and this is the onset of GERD and erosive esophagitis (EE). Current evidence of the effect of SG on GERD did not consolidate to a consensus. In this study, we objectively evaluate the incidence of EE 1 year post-LSG with upper endoscopy (EGD) and try to identify the significant variables and possible underlying mechanisms of the EE post-LSG...
September 21, 2018: Obesity Surgery
Syed Nabeel Zafar, Kaylie Miller, Jessica Felton, Eric S Wise, Mark Kligman
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common, safe and effective bariatric procedure. Bleeding is a significant source of postoperative morbidity. We aimed to determine the incidence, outcomes, and predictors of postoperative bleeding after LRYGB. METHODS: LRYGB patients included in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) 2015 dataset were identified. Preoperative and intraoperative factors were tested for associations with bleeding using univariable and multivariable logistic regression analysis...
September 19, 2018: Surgical Endoscopy
Daniel N Velasco Hernández, Santiago B De Battista, Héctor R Horiuchi, Maria M Zicavo
INTRODUCTION: Although carcinoid tumours are a rare gastrointestinal neoplasm with an incidence rate of 1-2.5 cases per 100 000 inhabitants, they are the most common neuroendocrine tumour of the stomach. PRESENTATION OF CASE: A 70-year-old-man consulted for epigastric pain and dyspepsia symptoms. His past medical and surgical history included obesity (BMI: 53.9 kg/m2 ), hypertension, hyperlipidemia, diabetes mellitus type 2, cardiac failure and a surgical treatment with laparoscopic gastric banding...
2018: International Journal of Surgery Case Reports
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