Anastomotic fistula after emergency enterectomy for retrograde intussusception after gastric bypass

2021 ◽  
Vol 14 (5) ◽  
pp. e240756
Author(s):  
Andre Lazaro ◽  
João Simões ◽  
Ana Valente da Costa ◽  
Luis Ventura
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Rare Complication ◽  
Emergency Setting ◽  
Retrograde Intussusception ◽  
The Future ◽  
Anastomotic Fistula ◽  
The Common ◽  
Adequate Management

Retrograde intussusception is a rare complication of gastric bypass. It is commonly located in the common limb close to the jejunojejunostomy. The management of such condition dictates the outcome of the patient either in the immediate emergency setting or in the long-term bariatric surgery’s expected results. We present a case of a retrograde intussusception 3 years after gastric bypass which warranted an emergency enterectomy, followed by an anastomotic fistula. The adequate management of these cases leads to recovery without compromising the effect of bariatric surgery in the future.

A Rare Complication of Bariatric Surgery: Retrograde Intussusception

2017 ◽  
Vol 27 (11) ◽  
pp. 2996-2998 ◽  
Author(s):  
Halis Bag ◽  
Serkan Karaisli ◽  
Salih Can Celik ◽  
Haldun Kar ◽  
Fatma Tatar
Keyword(s):  
Bariatric Surgery ◽  
Rare Complication ◽  
Retrograde Intussusception

scholarly journals Long-Term Quality of Life Outcomes After Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—a Comparative Study

2020 ◽  
Author(s):  
Cristina Fiorani ◽  
Sophie R. Coles ◽  
Myutan Kulendran ◽  
Emma Rose McGlone ◽  
Marcus Reddy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Metabolic Effects ◽  
Life Outcomes ◽  
Post Bariatric Surgery ◽  
Comorbidity Resolution

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.

scholarly journals Evaluation of the Effects of Bariatric Surgery in Terms of Weight Loss and Diabetes Remission in the Indian Population

2021 ◽  
pp. 1-7
Author(s):  
Manish Khaitan ◽  
Riddhish Gadani ◽  
Koshish Nandan Pokharel
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Complete Remission ◽  
Predictive Factors ◽  
Indian Population ◽  
Diabetes Remission ◽  
Obese Patients ◽  
Sustained Weight Loss

<b><i>Objectives:</i></b> The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. <b><i>Methods:</i></b> Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s <i>t</i> test and ANOVA and McNemar’s test were applied. <b><i>Results:</i></b> Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (<i>n</i> = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (<i>p</i> = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. <b><i>Conclusion:</i></b> Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.

Long-Term Impact of Bariatric Surgery

2017 ◽  
Author(s):  
Michael E. Hochman
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Abdominal Surgery ◽  
Vertical Banded Gastroplasty ◽  
Clinical Case ◽  
Long Term Impact ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in abdominal surgery. Does bariatric surgery in obese individuals reduce mortality? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible bariatric surgery, including gastric banding, vertical banded gastroplasty, or gastric bypass, for an obese man who has not had success with dieting.

scholarly journals New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The “Time-Within-Remission Range”

2020 ◽  
Vol 9 (4) ◽  
pp. 1070
Author(s):  
Ana de Hollanda ◽  
Albert Lecube ◽  
Miguel Angel Rubio ◽  
Enric Sánchez ◽  
Núria Vilarrasa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Diabetes Remission ◽  
Dynamic Responses ◽  
Type 2 Diabetes Remission

Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the “time-within-remission range” as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, “time-within-remission range” and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. “Time-within-remission range” were 83.3% (33.3–91.6) after gastric bypass, 68.7% (7.1–87.5) after sleeve gastrectomy and 90% (83.3–92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the “time-within-remission range”. The association of bariatric techniques with “time-within-remission range”, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34–5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40–0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The “time-within-remission range” unveils a superiority of gastric bypass compared to sleeve gastrectomy.

scholarly journals Emergency presentation of retrograde intussusception as a late complication of gastric bypass

2012 ◽  
Vol 94 (3) ◽  
pp. e116-e117 ◽  
Author(s):  
R Pande ◽  
I Fraser ◽  
C Harmston
Keyword(s):  
Gastric Bypass ◽  
Rare Complication ◽  
Late Complication ◽  
Emergency Presentation ◽  
Retrograde Intussusception ◽  
First Case ◽  
History Of ◽  
The Uk

Retrograde intussusception is a rare complication of a Roux-en-Y gastric bypass. With the rising number of gastric bypass operations being performed in the UK, the incidence of retrograde intussusception is likely to increase. We report the first case in the UK and highlight its insidious presentation and the importance of considering intussusception in any patient with a history of a Roux-en-Y gastric bypass.

Medium/long term evaluation of lipid profile after bariatric surgery (gastric bypass versus sleeve gastrectomy)

2021 ◽  
Author(s):  
Laura Abellán Garay ◽  
María Inmaculada Navarro García ◽  
Rafael González-Costea Martínez ◽  
Nuria María Torregrosa Pérez ◽  
José Luis Vázquez Rojas
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Lipid Profile ◽  
Term Evaluation

Comparative Effectiveness of Gastric Bypass and Vertical Sleeve Gastrectomy for Hypertension Remission and Relapse: The ENGAGE CVD Study

Hypertension ◽  
2021 ◽  
Author(s):  
Kristi Reynolds ◽  
Lee J. Barton ◽  
Anirban Basu ◽  
Heidi Fischer ◽  
David E. Arterburn ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Vertical Sleeve Gastrectomy ◽  
Variable Approach ◽  
Study Population ◽  
Instrumental Variable Approach

Weight loss is an effective strategy for the management of hypertension, and bariatric surgery is the most effective weight loss and maintenance strategy for obesity. The importance of bariatric surgery in the long-term management of hypertension and which operation is most effective is less clear. We compared the effectiveness of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) for remission and relapse of hypertension after surgery in the ENGAGE CVD cohort study (Effectiveness of Gastric Bypass Versus Gastric Sleeve for Cardiovascular Disease). Operations were done by 23 surgeons across 9 surgical practices. Hypertension remission and relapse were assessed in each year of follow-up beginning 30 days and up to 5 years postsurgery. We used a local instrumental variable approach to account for selection bias in the choice of VSG or RYGB. The study population included 4964 patients with hypertension at the time of surgery (n=3186 VSG and n=1778 RYGB). At 1 year, 27% of patients with RYGB and 28% of patients with VSG achieved remission. After 5 years, without accounting for relapse, 42% of RYGB and 43% of VSG patients had experienced hypertension remission. After accounting for relapse, only 17% of RYGB and 18% of VSG patients remained in remission 5 years after surgery. There were no statistically significant differences between VSG and RYGB for hypertension remission, relapse, or mean systolic and diastolic blood pressure at any time during follow-up.

scholarly journals Long-term Bone Loss and Deterioration of Microarchitecture After Gastric Bypass in African American and Latina Women

2020 ◽  
Author(s):  
Alexandra Krez ◽  
Sanchita Agarwal ◽  
Mariana Bucovsky ◽  
Donald J McMahon ◽  
Yizhong Hu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
African American ◽  
Bone Loss ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Latina Women ◽  
Mineral Density

Abstract Context The prevalence of obesity is burgeoning among African American and Latina women; however, few studies investigating the skeletal effects of bariatric surgery have focused on these groups. Objective To investigate long-term skeletal changes following Roux-en-Y gastric bypass (RYGB) in African American and Latina women. Design Four-year prospective cohort study. Patients African American and Latina women presenting for RYGB (n = 17, mean age 44, body mass index 44 kg/m2) were followed annually for 4 years postoperatively. Main Outcome Measures Dual-energy x-ray absorptiometry (DXA) measured areal bone mineral density (aBMD) at the spine, hip, and forearm, and body composition. High-resolution peripheral quantitative computed tomography measured volumetric bone mineral density (vBMD) and microarchitecture. Individual trabecula segmentation-based morphological analysis assessed trabecular morphology and connectivity. Results Baseline DXA Z-Scores were normal. Weight decreased ~30% at Year 1, then stabilized. Parathyroid hormone (PTH) increased by 50% and 25-hydroxyvitamin D was stable. By Year 4, aBMD had declined at all sites, most substantially in the hip. There was significant, progressive loss of cortical and trabecular vBMD, deterioration of microarchitecture, and increased cortical porosity at both the radius and tibia over 4 years. There was loss of trabecular plates, loss of axially aligned trabeculae, and decreased trabecular connectivity. Whole bone stiffness and failure load declined. Risk factors for bone loss included greater weight loss, rise in PTH, and older age. Conclusions African American and Latina women had substantial and progressive bone loss, deterioration of microarchitecture, and trabecular morphology following RYGB. Further studies are critical to understand the long-term skeletal consequences of bariatric surgery in this population.

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