Evolving Endoscopic Management Options for Symptomatic Stenosis Post-Laparoscopic Sleeve Gastrectomy for Morbid Obesity: Experience at a Large Bariatric Surgery Unit in New Zealand

2014 ◽  
Vol 25 (2) ◽  
pp. 242-248 ◽  
Author(s):  
Ravinder Ogra ◽  
Geogry Peter Kini
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
New Zealand ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Endoscopic Management ◽  
Management Options ◽  
Symptomatic Stenosis

scholarly journals Efficacy of laparoscopic sleeve gastrectomy for patient with morbid obesity and type 1 diabetes mellitus: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hidetaka Ichikawa ◽  
Hirofumi Imoto ◽  
Naoki Tanaka ◽  
Hiroaki Musha ◽  
Shojiro Sawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hba1c Level ◽  
Insulin Dose ◽  
Body Weight Loss

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.

scholarly journals Lithium toxicity following bariatric surgery

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095300 ◽  
Author(s):  
Suzanna Connick Jamison ◽  
Kelley Aheron
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Therapeutic Range ◽  
Lithium Therapy ◽  
Lithium Toxicity ◽  
Psychiatric Comorbidities ◽  
Monitoring Protocol

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient’s lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.

scholarly journals Acute paraoesophageal hiatal hernia following laparoscopic sleeve gastrectomy

2020 ◽  
Vol 7 (12) ◽  
pp. 4177
Author(s):  
Omar M. Alobaid ◽  
Abdullah S. Alzahrani ◽  
Bander I. Ali
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hiatal Hernia ◽  
Independent Risk Factor ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Significant Weight Loss ◽  
Operative Endoscopy

Anti-obesity surgery is the most effective therapy available for significant weight loss in patients with morbid obesity. Obesity in consider a major independent risk factor for Hiatal hernia (HH) and it is present in about 37%-50% of morbidly obese patients undergoing bariatric surgery.1,2,3 It might be overlooked or under looked especially if the patient was asymptomatic and no pre-operative endoscopy or radiological workup. Denovo closure of the hiatal defect in case of an intraoperative finding of HH strongly recommended preventing such acute postoperative complications. Herein we report a rare and acute post laparoscopic sleeve gastrectomy with gastric herniation were uneventfully diagnosed and interfered early to prevent a catastrophic outcome.  

Splenic Abscess Complicating Bariatric Surgery : A Systematic Review

2021 ◽  
pp. 000313482199197
Author(s):  
Md Mahfooz Buksh ◽  
Simon Tallowin ◽  
Ahmad Al Samaraee
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Splenic Abscess ◽  
Initial Operation ◽  
Management Options ◽  
Female Ratio ◽  
Objective Evidence ◽  
The Mean

Introduction Bariatric surgery has become one of the most rapidly growing subspecialty performed globally, and it has been well reported to be associated with low morbidity and mortality rates. Splenic abscess is a rare but serious complication of bariatric surgery that has not been previously systematically reviewed in the literature. Methods The authors have performed a systematic review of the evidence that has looked into the pathophysiology, clinical presentation, and the management options of splenic abscess complicating bariatric surgery. Results This systematic review has been unsurprisingly based on level-IV evidence due to the rarity of the explored condition. The final analysis included 27 relevant reported cases. The mean age was 38 years and the mean of the time interval between the initial operation and developing splenic abscess was 72 days, with the male to female ratio being 1:1.6. Laparoscopic sleeve gastrectomy was the initial operation in 85.2% of the patients. Nearly half of the patients did not have an objective evidence of local or systemic sepsis that could explain the abscess formation. Nonsurgical management was attempted in 14 patients, with 34% success rate only. Splenectomy was needed in 41.7% of the patients. No mortality was reported. Conclusions Splenic abscess is a rare and rather late but serious complication of bariatric surgery that could result in splenectomy in a relatively young group of patients. It is more commonly reported following laparoscopic sleeve gastrectomy. Early diagnosis with intervention in a timely manner is crucial to avoid life threatening complications.

scholarly journals Endolumenal Vacuum Therapy and Fistulojejunostomy in the Management of Sleeve Gastrectomy Staple Line Leaks

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Szymanski ◽  
Estrellita Ontiveros ◽  
James S. Burdick ◽  
Daniel Davis ◽  
Steven G. Leeds
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Staple Line ◽  
Source Control ◽  
Vacuum Therapy ◽  
Ischemic Tissue ◽  
Staple Line Leaks

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. EVAC therapy was abandoned, and FJ was performed to resolve the leak. Postoperatively, no leak was encountered requiring any additional procedures. Based on our findings, we conclude that EVAC therapy facilitates in resolving leaks that restore gastrointestinal continuity and maintain source control. It promotes healing and causes reperfusion of ischemic tissue and fistula cavity debridement.

Laparoscopic Sleeve Gastrectomy Versus Laparoscopicmini-Gastric Bypass in Management of Morbid Obesity and its Comorbidities

2020 ◽  
Vol 11 (2) ◽  
pp. 2572
Author(s):  
Tantawi Abdel Naeem Mohamed ◽  
Salah Abdel- Razik ◽  
Ayman Mohamed Hassanien ◽  
Tohamy A. Tohamy ◽  
Ashraf Abdel Azeem ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy
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