scholarly journals Mini-gastric bypass: Prevention and management of complications in performance and follow–up

2019 ◽  
Vol 71 ◽  
pp. 119-123 ◽  
Author(s):  
Mervyn Deitel ◽  
Robert Rutledge
2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mohsen Mahmoudieh ◽  
Behrouz Keleidari ◽  
Naser Afshin ◽  
Masoud Sayadi Shahraki ◽  
Shahab Shahabi Shahmiri ◽  
...  

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods. 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients’ BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.


2015 ◽  
Vol 11 (2) ◽  
pp. 321-326 ◽  
Author(s):  
Matthieu Bruzzi ◽  
Cédric Rau ◽  
Thibault Voron ◽  
Martino Guenzi ◽  
Anne Berger ◽  
...  

2010 ◽  
Vol 6 (3) ◽  
pp. S15 ◽  
Author(s):  
WeiJei Lee ◽  
YiChih Lee ◽  
JungChien Chen ◽  
KongHan Ser ◽  
YenHow Su ◽  
...  

2021 ◽  
Vol 14 (2) ◽  
pp. 92-106
Author(s):  
Aleksandra Igorevna Mitsinskaya ◽  
Vladimir Viktorovich Evdoshenko ◽  
Mikhail Borisovich Fishman ◽  
Alexey Yurievich Sokolov ◽  
V. Sergeevich Samoilov ◽  
...  

Background. Obesity is widely recognized as a disease that acquires the scale of an epidemic and is accompanied by a number of comorbidities, one of which is non-alcoholic fatty liver disease (NAFLD), while the issue of the impact of bariatric interventions on its course remains a subject of discussion, which determines the relevance of this study.Aims. Тo evaluate the impact of combined bariatric interventions - laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic mini-gastric bypass (LMGB-OAGB), - on the course of NAFLD and to determine the criteria that affect the dynamics of NAFLD after thеsе bariatric interventions.Materials and methods. The study included 56 patients who had one of 2 types of bariatric interventions performed between 2014 and 2017: LRYGB (26 (46,4%) patients) and LMGB-OAGB (30 (53,6%) patients). All patients underwent intraoperative liver biopsy, a range of laboratory and instrumental studies, FibroTest were calculated in dynamics. The frequency of complications in the postoperative period was estimated. The period of observation was 2 years. Results. In the group of laparoscopic Roux-en-Y gastric bypass 12 (46.2%) patients showed signs of liver fibrosis according to histological research, and 8 (30.8%) - signs of non - alcoholic steatohepatitis (NASH). There was an increase in transaminases in 5(19,2%), gamma-glutamyltranspeptidase (GGTP) in 19 (73.1%), and total bilirubin in 8 (30.8%) subjects. 20 (76.9%) participants had increased alkaline phosphatase (ALP), 22 (84.6%) had reduced high density lipoproteins (HDL) and increased triglycerides (TG). According to the results of ultrasound examination of the liver, 19 (73.1%) patients had enlarged liver size, 26 (100%) - diffuse heterogeneity, and 25 (96.2%) - hyperechogenicity. In the group of laparoscopic mini-gastric bypass, there were signs of liver fibrosis in 14 (46.7%) and NASH - in 14 (46.7%) patients. An increase in tranasminases was observed in 8 (26.7%), GGTP in 22 (73.3%), and total bilirubin in 6 (20%) patients. 9 (30%) of participants had increased ALP, 26 (86.7%) patients had reduced HDL and increased TG. 21 (70%) patients had enlarged liver size, 29 (96.7%) - diffuse heterogeneity, and 28 (93.3%) - hyperechogenicity.6 months after both types of interventions, there was a decrease in the clinical and biochemical characteristics of non-alcoholic fatty liver disease, which was transient and regressed by 1 year after surgery.After laparoscopic Roux-en-Y gastric bypass %EBMIL in 1 year was 75.25 [65.85-84.36] %. Normalization of transaminases was observed in 84.6%, cholestasis indicators in 87.2%, and FibroTest -in 46.2% of cases. % EBMIL 1 year after laparoscopic mini-gastric bypass was 74.77 [67.28-78.89] %. Normalization of transaminases was observed in 83.3%, cholestasis indicators in 78.9%, and FibroTest -in 43.3% of cases.Combined bariatric interventions were shown to be more effective in participants under 45 years of age compared to those over 45 years of age and in patients with initial stages of fibrosis F0-F2 by METAVIR compared to participants with stages F3-F4 by METAVIR. Patients with a BMI of more than 40 kg / m2 achieved higher FibroTest values after six months compared to subjects with a BMI of up to 40 kg/m2 and in fewer cases - FibroTest normalization by 1 year after surgery, respectively. The effectiveness of operations on the course of NAFLD was comparable.The results of the intervention on signs of non-alcoholic fatty liver disease were preserved for 2 years of postoperative follow-up. The mortality rate during the entire follow-up period was 0%. 47 (83,9%) patients were followed up to 2 years.Conclusion. Тhere was a high efficiency of RYGB and MGB-OAGB in patients with non-alcoholic fatty liver disease, while a transient aggravation of the course of non-alcoholic fatty liver disease was detected 6 months after the operation.Keywords: non-alcoholic fatty liver disease; obesity; metabolic syndrome; bariatric surgery; LRYGB; LMGB-OAGB; FibroTest; surgical intervention


2020 ◽  
Vol 92 (3) ◽  
pp. 1-5
Author(s):  
Piotr Kowalewski ◽  
Michał Janik ◽  
Andrzej Kwiatkowski ◽  
Krzysztof Paśnik ◽  
Maciej Walędziak

Introduction: Bariatric procedures are becoming more popular worldwide. We present current situation of foreign patients treated by high-volume bariatric surgeons in Poland in 2016. Material and Methods: We sent an online survey to twenty high-volume bariatric surgeons. The questionnaire regarded 2016. We asked for number and types of bariatric procedures performed or supervised, number of foreign bariatric patients, their qualification process, country of origin, types of procedure, and post-op recommendations. Results: We received 9 surveys (45%). Five surgeons performed or supervised from 100 to 300 bariatric procedures, 2 performed or supervised over 300 procedures, 2 performed or supervised from 50 to 100 procedures. All of the respondents performed laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB), four carried out mini gastric bypass, two – gastric banding (LAGB), one – SADI-S and duodenal switch (DS). Six surgeons operated on the total of 64 foreign patients, mainly performing LSG, LRYGB and mini gastric bypass. Most of the patients were qualified based on international criteria (BMI over 40 kg/m2 or BMI over 35 kg/m2 with comorbidities). United Kingdom was the most popular country of origin, followed by Germany, USA, Ireland and Sweden. Qualification for surgery was based on personal visit. After surgery 83.3% (n=5) of the respondents gave out discharge documents in English, recommending long term bariatric follow-up in the country of origin. Every respondent maintained 3-month personal follow-up of every foreign patient. Conclusions: Foreign bariatric patients travelling to Poland are qualified for surgery according to known international standards. Most of the patients receive post-op discharge documents in English, with a 3-month follow-up performed by their surgeon. Further bariatric supervision in the country of origin is routinely recommended.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A Abdelhamid ◽  
S Albalkiny ◽  
K Abdel-Samee ◽  
A Mustafa

Abstract Background Metabolic and bariatric surgery is a proven therapy for the treatment of obesity and its related comorbidities. Malabsorptive operations usually offer a higher rate of metabolic improvement, despite higher rate of complications and secondary effects. Objectives To compare Single Anastomosis Duodeno–Ileal bypass with Sleeve gastrectomy (SADIS) and Mini-Gastric Bypass operation as two types of bariatric surgeries with regard to weight loss, metabolic outcome and nutritional deficiencies within one year of post-operative follow up. Methods We performed a prospective comparison of 40 morbidly obese patients submitted to SADIS (n. = 20) and MGB (n. = 20) between July 2016 to July 2017 with one year of postoperative follow up. Results The groups were nearly similar in terms of age and sex. The SADI-S group had BMI of (47.4 vs 46.1) with 100% prevalence of DM in both groups, hypertension in SADIS 70% vs 65% in MGB and almost equal incidence of dyslipidemia. The SADI-S group presented markedly higher percentage of EWL of 91.4% vs 71.6% after one year. Control of DM, with HbA1c below 6%, was obtained in 85% in both groups with more decrease in mean HbA1c of SADIS being 5.44 vs 5.815 in MGB after one year. Most patients abandoned antidiabetic therapy or at least were controlled by less medications and lower doses. The SADI-S group presented remission of hypertension by 90% of patients as those of MGB but with far less medications. Lipid profile improvement was noticed in both groups with slightly higher resolution in SADIS group by 95% vs 90% for total cholesterol, 85% in both groups for T.G, 80% vs 85% for LDL, 65% vs 70% for HDL in SADIS and MGB patients respectively. Although the nutritional deficiency is still a considerable concern after SADIS, ours study didn’t show intense difference from MGB provided that proper vitamin supplementation and patient compliance are maintained postoperatively. Conclusion When compared to gastric bypass, SADI-S appears to be an effective and safe therapeutic technique with excellent short-term results for treating morbid obesity and its associated comorbidities with a low rate of nutritional complications. Proving its safety and efficacy by further studies will grant it more popularity in the future.


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