scholarly journals The Importance of Intestinal Length in Triglyceride Metabolism and in Predicting the Outcomes of Comorbidities in Laparoscopic Roux-en-Y Gastric Bypass—a Narrative Review

2021 ◽  
Author(s):  
Pirjo Käkelä ◽  
Tuomo Rantanen ◽  
Kirsi A. Virtanen
Keyword(s):  
Gastric Bypass ◽  
Small Intestine ◽  
Narrative Review ◽  
Food Passage ◽  
Metabolic Outcomes ◽  
Intestinal Length ◽  
Common Endpoint ◽  
Intestine Length ◽  
Remission Of Comorbidities

AbstractIn this narrative review, we will appraise if modification of the length of bypassed small intestine based on measured total small intestinal length could optimize the outcomes of the laparoscopic Roux-en-Y gastric bypass (LRYGB). We provide a summary of carefully selected studies to serve as examples and to draw tentative conclusions of the effects of LRYGB on remission of comorbidities. As the heterogeneity of the included studies varied in terms of outcomes, type of study, length of the bypassed small intestine, and the follow-up, a common endpoint could not be defined for this narrative article. To achieve efficient metabolic outcomes, it is important to carefully choose the small intestine length excluded from the food passage suited best to each individual patient. Graphical abstract

Short-Term Results of Single-Anastomosis Gastric Bypass After Failed Sleeve Gastrectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alaa Abbas Sabry ◽  
Karim Sabry Abd-Elsamee ◽  
Mohamed Ibrahim Mohamed ◽  
Mohammed Mohamed Ahmed Abd-Elsalam
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Weight Regain ◽  
Revisional Surgery ◽  
One Anastomosis Gastric Bypass ◽  
Short Term ◽  
Multicenter Studies ◽  
Metabolic Outcomes

Abstract Background It is already known that Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain is considered as a complication. Demand for secondary surgery is rising, partly for this reason, but through that study we try to discover the efficacy of conversion of failed sleeve gastrectomy to one anastomosis gastric bypass (OAGB) regarding weight loss and metabolic outcomes. Objective To asses the efficacy and safety of one anastomosis gastric bypass (OAGB) as a conversion surgery post Sleeve Gastrectomy failure as regard weight loss and metabolic outcomes. Patients and Methods This study is a retrospective cohort study which included 20 patients underwent one anastomosis gastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric center, Cairo, Egypt From February 2019 to July 2019 with 6 months of postoperative follow up till January 2019. Results In this study, we reviewed and analyzed the outcomes from the revision of the SG due to either inadequate weight loss or weight regain to one anastomosis gastric bypass (OAGB) with %EBWL of 6.65% at 1 month, 13.61 % at 3 months and 20.86% at 6 months. Conclusion OAGB appears to be an effective and safe therapeutic technique as a revisional surgery for failed primary SG with good short-term results for treating morbid obesity and its associated comorbidities with a significantly low rate of complications. However the EBWL was less than what is reported after primary OAGB weight. Multicenter studies with larger series of patients and longer term follow up after SG revisions to OAGB are warranted.

Development of Fetal Intestinal Length during 2nd-Trimester in Normal and Pathologic Pregnancies

2012 ◽  
Vol 15 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Andreas Marnerides ◽  
Sam Ghazi ◽  
Anders Sundberg ◽  
Nikos Papadogiannakis
Keyword(s):  
Small Intestine ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Chromosomal Abnormalities ◽  
Intestinal Resection ◽  
Clinical Importance ◽  
Additional Parameter ◽  
Linear Measurements ◽  
Intestinal Length ◽  
Intestine Length

Linear growth of the human fetal gastrointestinal tract is not often discussed in the literature, and little is known about the effects of chromosomal abnormalities and intrauterine growth restriction (IUGR) on intestinal length, especially during the 2nd trimester. Accurate evaluation of intestinal length and knowledge of normal and reference values are of clinical importance. For example, intestinal resection may be necessary in preterm infants with necrotizing enterocolitis or mid-gut volvulus, and the surgeon should use data to be judicious in the amount removed. Linear measurements are essential in evaluating fetal development ultrasonographically and are an integral part of the postmortem examination. The intestinal lengths of 203 2nd-trimester fetuses and premature infants were measured. Small intestine length (SIL), colon length (CL), total bowel length (TBL; TBL = SIL + CL), and the length of the appendix (AL) increased with gestational age. No differences between the genders were observed. Colon length increased secondary to maceration, but no such effects were shown on SIL, TBL, or AL. No differences were shown in relation to IUGR. Small intestine length, CL, and TBL, but not AL, were shorter in fetuses with trisomy 21. Appendix length was not affected by any of the studied factors. We propose that the measurement of the length of the appendix may be used as an additional parameter for the postmortem evaluation of gestational age. Furthermore, its assessment may have potential as an ultrasonographic indicator of gestational age, particularly for the 2nd trimester.

scholarly journals Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

2021 ◽  
Vol 10 (4) ◽  
pp. 674
Author(s):  
Daniel Moritz Felsenreich ◽  
Felix Benedikt Langer ◽  
Jakob Eichelter ◽  
Julia Jedamzik ◽  
Lisa Gensthaler ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Small Bowel ◽  
Weight Regain ◽  
Food Passage ◽  
Small Bowel Length ◽  
Single Anastomosis ◽  
Restrictive Procedures ◽  
Remission Of Comorbidities ◽  
Ileal Bypass

The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.

scholarly journals Long-Term Weight Loss Results, Remission of Comorbidities and Nutritional Deficiencies of Sleeve Gastrectomy (SG), Roux-En-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) on Type 2 Diabetic (T2D) Patients

2020 ◽  
Vol 17 (20) ◽  
pp. 7644
Author(s):  
Maria-Jose Castro ◽  
Jose-Maria Jimenez ◽  
Miguel-Angel Carbajo ◽  
Maria Lopez ◽  
Maria-Jose Cao ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
The Other ◽  
Nutritional Deficiencies ◽  
Remission Of Comorbidities ◽  
Type 2 Diabetic

This study aimed to compare the long-term weight loss results, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. Patients and Methods: A retrospective analysis of all the morbidly obese and diabetic patients undergoing SG, RYGB, and OAGB as primary bariatric procedures between February 2010 and June 2015 was performed. Anthropometric parameters, remission of comorbidities, nutritional deficiencies and supplementation requirements at 1, 2 and 5 years’ follow-up were monitored. Patients lost to follow-up 5 years after surgery were excluded from the analysis. Results: 358 patients were included. The follow-up rate was 84.8%. Finally, 83 SG, 152 RYGB, and 123 OAGB patients were included in the analysis. OAGB obtained significantly greater weight loss and remission of dyslipidemia than the other techniques. There was a trend towards greater T2D and hypertension remission rate after OAGB, while fasting glucose and glycated hemoglobin levels were significantly lower after OAGB. There were no significant differences in hemoglobin or protein levels between groups. SG obtained lower iron deficiencies than the other techniques, while there were no significant differences in other nutritional deficiencies between groups. Conclusion: OAGB obtained greater weight loss and remission of dyslipidemia than RYGB or SG. Excluding lower iron deficiency rates after SG, there were no significant differences in the development of nutritional deficiencies between groups.

scholarly journals Effects of sleeve gastrectomy versus omega-loop gastric bypass. What is best for weight loss, perioperative adverse events, and comorbidities?

2021 ◽  
Vol 12 (2) ◽  
pp. 219-231
Author(s):  
Omar Thaher ◽  
Jamal Driouch ◽  
Martin Hukauf ◽  
Christine Stroh
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Perioperative Complications ◽  
Omega Loop Gastric Bypass ◽  
Significant Difference ◽  
Omega Loop ◽  
One Year ◽  
Remission Of Comorbidities ◽  
Loop Gastric Bypass

Aim of the study: This study investigated whether Sleeve Gastrectomy (SG) or Omega-Loop-Gastric-Bypass (OAGB) has the best benefit in weight loss, perioperative risk, and remission of comorbidities. Methods: 29,407 patients after SG and OAGB were included in the German Bariatric Surgery Registry (GBSR). Outcome criteria were perioperative morbidity, perioperative complications, and remission of comorbidities after one year of follow-up. Results: 15,169 patients had completed 1-year follow-up (770 patients after OAGB and 14,399 after SG). The %EWL was higher for OAGB than for SG (70.4 ± 18.5 for OAGB and 62.4 ± 22.6 for SG; p<0.001). BMI reduction was also a significant difference in favor of OAGB (17.5 ± 5.6 kg/m2 for OAGB vs. 15.5 ± 5.9 for SG; p<0.001). There was no significant difference between the two groups in perioperative complications (p<5%). Significant differences in favor of OAGB were found in remission of hypertension (p<0.001), IDDM (p<0.001), NIDDM (p<0.001), reflux (p<0.001), and sleep apnea (p<0.001). Conclusion: Our analysis showed that OAGB surgery was associated with more significant BMI reduction and weight loss one year after surgery. In addition, OAGB surgery was significantly more effective in improving obesity-related comorbidities. Our results support the performance of OAGB over SG in patients with obesity and comorbidities. However, the contraindications and general condition of the patient should be considered in the context of this.

scholarly journals Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score–Matched Analysis

2021 ◽  
Author(s):  
Ziad Abbassi ◽  
Lorenzo Orci ◽  
Jeremy Meyer ◽  
Sebastian Douglas Sgardello ◽  
Nicolas Goossens ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Nonalcoholic Steatohepatitis ◽  
Hepatocellular Injury ◽  
Nonalcoholic Fatty Liver ◽  
Simple Steatosis ◽  
Metabolic Outcomes

Abstract Purpose It is currently unknown whether NASH (nonalcoholic steatohepatitis), as compared to simple steatosis, is associated with impaired postoperative weight loss and metabolic outcomes after RYGB surgery. To compare the effectiveness of Roux-en-Y gastric bypass (RYGB) on patients with NASH versus those with simple nonalcoholic fatty liver (NAFL). Materials and Methods We retrospectively retrieved data from 515 patients undergoing RYGB surgery with concomitant liver biopsy. Clinical follow-up and metabolic assessment were performed prior to surgery and 12 months after surgery. We used multivariate analysis of variance (MANOVA) and propensity score matching and we assessed for changes in markers of hepatocellular injury and metabolic outcomes. Results There were 421 patients with simple NAFL, and 94 with NASH. Baseline alanine and aspartate aminotransferases were significantly higher in patients with NASH (p < 0.01). Twelve months after the RYGB surgery, as determined by both MANOVA and propensity score matching, patients with NASH exhibited a significantly greater reduction in alanine aminotransferase (ß-coefficient − 12 iU/l [− 22 to − 1.83], 95% CI, adjusted p = 0.021) compared to their NAFL counterparts (31 matched patients in each group with no loss to follow-up at 12 months). Excess weight loss was similar in both groups (ß-coefficient 4.54% [− 3.12 to 12.21], 95% CI, adjusted p = 0.244). Change in BMI was comparable in both groups (− 14 (− 16.6 to − 12.5) versus − 14.3 (− 17.3 to − 11.9), p = 0.784). Conclusion After RYGB surgery, patients with NASH experience a greater reduction in markers for hepatocellular injury and similar weight loss compared to patients with simple steatosis.

Sign in / Sign up

Export Citation Format

Share Document