roux-en-y gastric bypass

Sandra Baile-Maxía, Lucía Medina-Prado, Maryana Bozhychko, Carolina Mangas-Sanjuan, Francisco Ruiz, Luis Compañy, Juan Martínez, Juan Antonio Casellas, José Ramón Aparicio
Percutaneous endoscopic gastrostomy (PEG) is the method of choice for feeding and nutritional support in patients with a normal gastrointestinal function who require long-term enteral nutrition. We report our experience regarding an alternative endoscopic ultrasound (EUS)-guided PEG technique. A retrospective clinical experience case series study was conducted from January 2019 to November 2019 at a tertiary center. Adult patients deemed unfit for conventional PEG due to absence of transillumination or previous gastric surgery were enrolled...
April 4, 2020: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
O Cadart, O Degrandi, T Barnetche, N Mehsen-Cetre, M Monsaingeon-Henry, E Pupier, L Bosc, D Collet, C Gronnier, F Tremollieres, Blandine Gatta-Cherifi
INTRODUCTION: Bone mineral density (BMD) declines in the initial years after bariatric surgery, but long-term skeletal effects are unclear and comparisons between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are rare. DESIGN AND METHODS: An observational longitudinal study of obese patients undergoing SG or RYGB was performed. Whole-body (WB) BMD, along with BMD of the total hip (TH), femoral neck (FN), and lumbar spine (LS), was measured by dual-energy X-ray absorptiometry (DXA) before surgery and yearly thereafter for 4 years...
April 3, 2020: Obesity Surgery
Benjamin Clapp, William Klingsporn, Isaac Lee, Evan Liggett, Ashtyn Barrientes, Brittany Harper, Alan Tyroch
BACKGROUND: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) tracks 30-day outcomes of bariatric patients, but only at accredited centers. Presently, these cases are not broken down by state. Administrative databases can be used to answer some of the questions that are not asked by clinical databases and also to validate those databases. We proposed using the inpatient and outpatient administrative databases in Texas to examine both the numbers and trends of bariatric surgery in Texas over a 5-year period...
April 3, 2020: Surgical Endoscopy
Jason A Davis, Rhodri Saunders
BACKGROUND: Bariatric surgery, such as Roux-en-Y gastric bypass [RYGB] has been shown to be an effective intervention for weight management in select patients. After surgery, different patients respond differently even to the same surgery and have differing weight-change trajectories. The present analysis explores how improving a patient's post-surgical weight change could impact co-morbidity prevalence, treatment and associated costs in the Canadian setting. METHODS: Published data were used to derive statistical models to predict weight loss and co-morbidity evolution after RYGB...
April 3, 2020: BMC Health Services Research
John R Montgomery, Jordan A Cohen, Craig A Brown, Kyle H Sheetz, Grace F Chao, Seth A Waits, Dana A Telem
Bariatric surgery is effective among patients with previous transplant in limited case series. However, the perioperative safety of bariatric surgery in this patient population is poorly understood. Therefore, we assessed the safety of bariatric surgery among previous-transplant patients using a database that captures >92% of all U.S. bariatric procedures. All primary, laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass procedures between 2017-2018 were identified from the MBSAQIP dataset. Patients with previous transplant (n=610) were compared to patients without previous transplant (n=321,447)...
April 3, 2020: American Journal of Transplantation
Barbara Cresci, Claudia Cosentino, Matteo Monami, Edoardo Mannucci
AIM: Aim of this network-meta-analysis (NMA) was to compare different types of metabolic surgery (MS) with medical therapy (MT) for the treatment of type 2 diabetes (T2D). MATERIALS AND METHODS: This NMA includes randomized clinical trials comparing different MS techniques versus MT inT2D, with a duration of ≥ 24 weeks. Primary endpoints were HbA1c, fasting plasma glucose (FPG) and diabetes remission. Indirect comparisons of different types of surgery were performed by NMA...
April 3, 2020: Diabetes, Obesity & Metabolism
P Blanc, C Breton, C Kuperas
No abstract text is available yet for this article.
March 30, 2020: Journal of Visceral Surgery
Petter Bjornstad, Edward Nehus, Daniel van Raalte
Bariatric surgery, an emerging treatment for severely obese youth with and without T2D, provides marked improvement in insulin resistance, beta-cell function, and central adiposity. Further, preliminary data suggest that bariatric surgery also results in significant improvement in markers of obesity-related nephropathy and DKD, beyond that which can be achieved with current medical interventions. Yet, the mechanisms whereby bariatric surgery attenuates kidney disease remain unclear. This review summarizes the data on the effects of bariatric surgery on obesity-related nephropathy and DKD in youth with and without T2D, in addition to potential mechanisms underlying the nephroprotective effects of weight loss surgery and how these may differ in Roux-en-Y gastric bypass vs...
February 2020: Seminars in Pediatric Surgery
Petter Bjornstad, Edward Nehus, Todd Jenkins, Mark Mitsnefes, Marva Moxey-Mims, John B Dixon, Thomas H Inge
Bariatric surgery improves markers of kidney health in severe obesity, yet it is unclear if kidney disease outcomes differ according to age at surgery. Therefore, we examined health effects of Roux-en-Y gastric bypass between 161 adolescents and 396 adults participating in two related but distinct studies. Primary outcomes were elevated urine albumin-to-creatinine ratio (UACR) of 30 mg/g or more and hyperfiltration (an estimated glomerular filtration rate of 135 ml/min/1.73m2 or more). Analyses were stratified by the presence of pre-operative type 2 diabetes...
February 3, 2020: Kidney International
J C Nwanaji-Enwerem, A Landry
A 29-year-old woman with a history of obesity status post Roux-en-Y gastric bypass greater than five years prior presented to the emergency department with four hours of sudden-onset stabbing left-sided abdominal pain associated with nausea and non-bloody emesis. She denied melaena and hematochezia, but did report two weeks of diarrhoea that was unchanged with this new onset abdominal pain.
2020: Acute Medicine
Matthew D Spann, Noah J Harrison, Wayne J English, Aaron R Bolduc, Chetan V Aher, D Brandon Williams, Alexander T Hawkins
Roux-en-Y gastric bypass (RYGB) has been explored as a revisional option to failed paraesophageal hernia (PEH) repair with fundoplication, particularly in patients suffering from obesity. However, few studies have assessed long-term outcomes of RYGB with revisional PEH repair in regard to acid-suppressing medication use. We retrospectively identified 19 patients who underwent revisional PEH repair with RYGB between 2011 and 2018. The median operative time was 232 minutes with a median hospital length of stay of two days...
March 1, 2020: American Surgeon
Sergio Carandina, Antoine Soprani, Laura Montana, Sebastien Murcia, Antonio Valenti, Marc Danan, Jacopo d'Agostino, Emmanuel Rivkine, Marius Nedelcu
BACKGROUND: The main side effect of long-term laparoscopic sleeve gastrectomy is the onset of severe gastroesophageal reflux disease (GERD). OBJECTIVES: The aim of this study was to evaluate the effectiveness of gastric bypass conversion in controlling postsleeve GERD. SETTING: University Hospital and Private Hospital, France and Private Hospital, Italy. METHODS: This retrospective multicenter study included patients who underwent laparoscopic sleeve gastrectomy and suffered from postoperative GERD, who did not respond to medical treatment and were converted to laparoscopic Roux-en-Y gastric bypass...
February 22, 2020: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Manuela Schoeb, Andrea Räss, Nicola Frei, Stefan Aczél, Michael Brändle, Stefan Bilz
BACKGROUND: Iron deficiency is a common finding in patients with previous bariatric surgery, and parenteral supplementation is frequently required. Ferric carboxymaltose (FCM) is among the preferred compounds used but may be associated with new-onset hypophosphatemia. This study was undertaken to study the prevalence of hypophosphatemia following FCM in patients with previous bariatric surgery, a population that may be at particular risk due to highly prevalent secondary hyperparathyroidism...
March 27, 2020: Obesity Surgery
Wanda Lam, Gi Yoon Kim, Clayton Petro, Adel A Saleh, Leena Khaitan
BACKGROUND: Operating room (OR) efficiency requires coordinated teamwork between the staff surgeon, anesthesia team, circulating nurse, surgical technician, and surgical trainee or assistant. Bariatric cases present unique challenges including difficult airways, challenging intravenous access, use of specialized surgical equipment, and synchronized exchange of orogastric tubes. The high contribution margin of these complex bariatric procedures rests on OR efficiency. OBJECTIVE: To compare the efficiency of bariatric surgeries performed by a single surgeon at a tertiary academic medical center with its inherent variability of OR staff to that of a private hospital with a standardized surgical team...
March 27, 2020: Surgical Endoscopy
Vitor Ottoboni Brunaldi, Galileu Ferreira Ayala Farias, Daniel Tavares de Rezende, Gabriel Cairo-Nunes, Daniel Riccioppo, Diogo Turiani Hourneaux de Moura, Marco Aurelio Santo, Eduardo Guimarães Hourneaux de Moura
BACKGROUND AND AIMS: A significant portion of patients regain weight after Roux-en-Y gastric bypass (RYGB). Both ablation with argon plasma coagulation (APC) plus endoscopic full-thickness suturing (FTS-APC) and ablation alone have been reported at treating weight regain when associated with gastrojejunostomy (GJ) dilation. However, comparative controlled data are still lacking. METHODS: This was a pilot single-center open-label randomized trial comparing the effectiveness and safety of APC alone versus FTS-APC in performing transoral outlet reduction...
March 23, 2020: Gastrointestinal Endoscopy
M M G van Berckel, J C Ederveen, J Nederend, S W Nienhuijs
PURPOSE: Weight loss is one of the desired outcomes after a gastric bypass, in order to reduce co-morbidity, and even mortality. However, weight loss might contribute to a serious complication: internal herniation (IH). Pre-operative diagnosis of IH is demanding. This study was conducted to investigate if percentage total weight loss (%TWL) is clinically usable in recognizing patients with IH. MATERIALS AND METHODS: Patients who had undergone a gastric bypass between 2011 and 2014 were included retrospectively if a CT scan or reoperation was performed for suspected IH between 2011 and 2016...
March 25, 2020: Obesity Surgery
Tigran Poghosyan, Matthieu Bruzzi, Claire Rives-Lange, Sebastien Czernichow, Jean-Marc Chevallier, Richard Douard
In some cases, in addition to the usual difficulties that the bariatric surgeon may encounter during standard bariatric procedures, anatomical anomalies such as situs inversus can pose an additional technical challenge. A 58-year-old patient with total situs inversus underwent Roux-en-Y gastric bypass (RYGB) surgery in our department. The main difficulty was the realization of a mirrored RYGB. Laparoscopic RYGB in a patient with situs inversus totalis is feasible but requires significant concentration and three-dimensional coordination to perform the mirrored procedure...
March 24, 2020: Obesity Surgery
Yao C Huang, David Mitchell
Roux-en-Y gastric bypass (RYGB) is the second most common bariatric procedure performed in Australia, second to sleeve gastrectomy. Banding of pouches and anastomoses, via silastic bands or MiniMizer rings, have been used to assist in improving restriction. Though banded gastric bypasses are effective in weight loss, band migration, whether it be slippage or erosion, occurs in up to 7% of banded bariatric procedures. Jejunal intussusception and internal herniation are both individually known complications of RYGB...
March 2020: Journal of Surgical Case Reports
Kleopatra Alexiadou, Joyceline Cuenco, James Howard, Nicolai Jacob Wewer Albrechtsen, Ibiyemi Ilesanmi, Anna Kamocka, George Tharakan, Preeshila Behary, Paul R Bech, Ahmed R Ahmed, Sanjay Purkayastha, Robert Wheller, Matthieu Fleuret, Jens Juul Holst, Stephen R Bloom, Bernard Khoo, Tricia M-M Tan
INTRODUCTION: Hyperglucagonemia is a key pathophysiological driver of type 2 diabetes. Although Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for diabetes, it is presently unclear how surgery alters glucagon physiology. The aim of this study was to characterize the behavior of proglucagon-derived peptide (glucagon, glucagon-like peptide-1 (GLP-1), oxyntomodulin, glicentin) secretion after RYGB surgery. RESEARCH DESIGN AND METHODS: Prospective study of 19 patients with obesity and pre-diabetes/diabetes undergoing RYGB...
March 2020: BMJ Open Diabetes Research & Care
Fabio Butti, Olivier Tobler, Pierre Allemann, Pierre Fournier
Background: Gastroesophageal reflux disease (GERD) is one of the most important obesity-related comorbidity, with prevalence >50% in obese population. Roux-en-Y gastric bypass (RYGB) is considered the gold standard for metabolic surgery in obese patients with GERD, but in a subgroup of patients this pathological GERD may be not really controlled after this technique. Aims of this article are to discuss surgical and endoscopic options to manage refractory GERD after RYGB. Materials and Methods: We realized a literature review using the PubMed database and searching articles published before December 2019 about GERD after RYGB...
March 25, 2020: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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