Risk of Asymptomatic Gallstones Becoming Symptomatic After Laparoscopic Sleeve Gastrectomy

2021 ◽  
pp. 000313482110111
Author(s):  
Ozan Şen ◽  
Ahmet G. Türkçapar
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Retrospective Study ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Abdominal Ultrasound ◽  
Concomitant Cholecystectomy ◽  
Study Population ◽  
The Mean ◽  
Asymptomatic Gallstones

Background Whether concomitant cholecystectomy is needed during laparoscopic sleeve gastrectomy (LSG) in patients with asymptomatic cholelithiasis is controversial. In this study, our aim is to show the follow-up results in patients with asymptomatic cholelithiasis who underwent LSG alone. Methods Patients undergoing primary LSG between March 2018 and September 2020 with asymptomatic gallbladder stones were included in this retrospective study. All patients underwent abdominal ultrasound (US) before surgery. Patients’ demographics and postoperative outcomes were recorded. Results A total of 180 patients underwent primary LSG and completed the 1-year follow-up. The study population consisted of 42 patients (23%) with asymptomatic cholelithiasis. The mean age was 41.1±7.1 years (31-56, 63% female), and mean body mass index (BMI) was 44 ± 6.7 kg/m2. Average BMI decreased to 31.1 ± 4.7 kg/m2 at 6 months and to 27.3 ± 3.6 kg/m2 at 1 year. The average follow-up period was 17 ± 5.7 months (range, 12-28 months). Of the 42 patients, only 1 patient (2.4%) became symptomatic during the follow-up period. Discussion We do not recommend cholecystectomy in patients with asymptomatic gallstones during the same session with LSG. An observational approach should be adopted for these patients.

Incidence of cholelithiasis after laparoscopic sleeve gastrectomy

2020 ◽  
Vol 2 (2) ◽  
pp. 63-69
Author(s):  
Iea Alabbasi ◽  
Issam Merdan ◽  
Falih Al-Gazgooz
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Weight Reduction ◽  
Gallstone Formation ◽  
Abdominal Ultrasound ◽  
Gallbladder Polyps ◽  
Concomitant Cholecystectomy ◽  
History Of ◽  
Age Range

Background: Laparoscopic sleeve gastrectomy is a well-known method for weight reduction. Post-operative weight loss is a major risk factor for gallstone formation. Objective: To determine whether prophylactic concomitant laparoscopic cholecystectomy should be performed on all patients at the time of laparoscopic sleeve gastrostomy or not. Patients and Methods: A retrospective and prospective study on 540 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy; their BMI range was between 38 and 53, their age range was 18 to 63 years, and 335 of them were females. The exclusion criteria were patients with a history of cholecystectomy, gallstone patients or gallbladder polyps more than 1 cm in preoperative abdominal ultrasound, and those who failed to follow-up. All patients were followed up with every 6–12 months, including those who had cholecystectomy by other surgeons. Results: During the study period, from the total 540 patients who had laparoscopic sleeve gastrectomy, 167 patients (30.92%) had cholecystectomy, out of which 20 patients (3.7%) had achieved 45% weight reduction during the first six months; while in another 6 months, 147 patients (27.22%) had cholecystectomy, achieving additional 30% weight reduction. Conclusions: The incidence of gallstones after laparoscopic sleeve gastrostomy is about 30.92%, indicating that 69.08% will not have gallstones in the postoperative follow-up period, so it would be unwise to do prophylactic concomitant cholecystectomy for all patients. Keywords: Bariatric procedures, cholecystectomy, incidence

Endoscopic Insertion Of A Self-Expandable Stent Combined With Laparoscopic Rinsing Of Peritoneal Cavity As A Method For Staple Line Leaks Treatment In Patients Post Laparoscopic Sleeve Gastrectomy

2015 ◽  
Vol 87 (5) ◽  
Author(s):  
Maciej Matłok ◽  
Piotr Major ◽  
Michał Pędziwiatr ◽  
Marek Winiarski ◽  
Piotr Budzyński ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Peritoneal Cavity ◽  
Staple Line ◽  
Results Of Treatment ◽  
Staple Line Leaks ◽  
Endoscopic Insertion ◽  
The Mean ◽  
Mean Time

AbstractCurrently, laparoscopic sleeve gastrectomy is one of bariatric surgeries most commonly performed in the world. The most frequent complications of surgeries of this type, with the highest mortality rate, include bleeding into the GI tract and peritoneal cavity, and sleeve staple line leaks. These severe complications prolong the hospital stay, and often are a cause of patient’s death. While in a case of bleeding the procedure appears to be obvious, so far no uniform and standard guidelines have been established for the group of patients with staple line leaks.was to report results of treatment for staple line leaks following laparoscopic sleeve gastrectomy with a laparoscopic procedure and simultaneous endoscopic insertion of a self-expandable stent.152 laparoscopic sleeve gastrectomies were performed from April 2009 to December 2014. The BMI median was 46.9, and the age median was 42 years. Staple line leaks developed in 3 out of 152 people (1.97%). All patients who developed this complication were included in the study. The treatment involved laparoscopic revision surgery with simultaneous endoscopic insertion of a self-expandable stent (Boston Scientific, Wallflex Easophageal Stent, 150×23 mm) into the gastric stump during gastroscopy.Leaks following laparoscopic sleeve gastrectomy were diagnosed on day 5 after the procedure, on average. Intervention consisting of laparoscopy and endoscopic insertion of a self-expandable stent was initiated within 14 hours of diagnosing the leak, on average. The mean time for which the stent was kept was 5 weeks (4–6 weeks). Stenting proved to be fully effective in all patients, where after discharging home, a cutaneous fistula, periodically (every 2-3 weeks) discharging several millilitres of matter, persisted in one patient. The mean time for the leak healing in 2 patients, in whom the described method was successful in treatment of this complication, was 37 days. No patient died in the perioperative or follow-up period.The proposed method for treatment of staple line leaks following laparoscopic sleeve gastrectomy by combined laparoscopic rinsing and draining of the peritoneal cavity and endoscopic insertion of a self-expandable stent is an interesting and worth recommending method for treatment of this complication.

scholarly journals Prophylactic adjacent-segment vertebroplasty following kyphoplasty for a single osteoporotic vertebral fracture and the risk of adjacent fractures: a retrospective study and clinical experience

2016 ◽  
Vol 25 (4) ◽  
pp. 528-534 ◽  
Author(s):  
Martin C. Eichler ◽  
Christian Spross ◽  
Alexander Ewers ◽  
Ryan Mayer ◽  
Fabrice A. Külling
Keyword(s):  
Retrospective Study ◽  
Osteoporotic Fractures ◽  
Adjacent Segment ◽  
Single Segment ◽  
Vertebral Body Fractures ◽  
Study Population ◽  
The Mean ◽  
Adjacent Fractures ◽  
Adjacent Vertebra

OBJECTIVE This study investigated the benefit of prophylactic vertebroplasty of the adjacent vertebrae in single-segment osteoporotic vertebral body fractures treated with kyphoplasty. METHODS All patients treated with kyphoplasty for osteoporotic single-segment fractures between January 2007 and August 2012 were included in this retrospective study. The patients received either kyphoplasty alone (kyphoplasty group) or kyphoplasty with additional vertebroplasty of the adjacent segment (vertebroplasty group). The segmental kyphosis with the rate of adjacent-segment fractures (ASFs) and remote fractures were studied on plain lateral radiographs preoperatively, postoperatively, at 3 months, and at final follow-up. RESULTS Thirty-seven (82%) of a possible 45 patients were included for the analysis, with a mean follow-up of 16 months (range 3–54 months). The study population included 31 women, and the mean age of the total patient population was 72 years old (range 53–86 years). In 21 patients (57%), the fracture was in the thoracolumbar junction. Eighteen patients were treated with additional vertebroplasty and 19 with kyphoplasty only. The segmental kyphosis increased in both groups at final follow-up. A fracture through the primary treated vertebra (kyphoplasty) was found in 4 (22%) of the vertebroplasty group and in 3 (16%) of the kyphoplasty group (p = 0.6). An ASF was found in 50% (n = 9) of the vertebroplasty group and in 16% (n = 3) of the kyphoplasty group (p = 0.03). Remote fractures occurred in 1 patient in each group (p = 1.0). CONCLUSIONS Prophylactic vertebroplasty of the adjacent vertebra in patients with single-segment osteoporotic fractures as performed in this study did not decrease the rate of adjacent fractures. Based on these retrospective data, the possible benefits of prophylactic vertebroplasty do not compensate for the possible risks of an additional cement augmentation.

scholarly journals Comparison of the effects of laparoscopic sleeve gastrectomy in adults and adolescents

2020 ◽  
Vol 7 (3) ◽  
pp. 630
Author(s):  
Burcin Batman ◽  
Hasan Altun
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Insulin Level ◽  
Benefit Evaluation ◽  
Significant Difference ◽  
Adolescents And Adults ◽  
Treatment Of Obesity

Background: Obesity is an increasing problem worldwide regardless of age. Bariatric surgery is highly effective both in the treatment of obesity and in the improvement of obesity-related comorbidities. Laparoscopic sleeve gastrectomy is gaining popularity in both adolescents and the elderly.Methods: A total of 64 patients who underwent laparoscopic sleeve gastrectomy, aged under 19 and older 65 between March 2013 and December 2019 were enrolled in this retrospective study. Demographic characteristics were recorded in all patients.Results: Between March 2013 and December 2019, 64 patients who underwent laparoscopic sleeve gastrectomy were enrolled in this study. Fourty-five patients were smaller than 19 years old and 19 patients were older than 65 years old. After 1-year follow-up, there was a significant improvement in glucose, insulin level, excess weight loss and body mass index in both groups (p<0.001). There was no significant difference in insulin levels (p=0.2) and body mass index (p=0.94) between two groups.Conclusions: Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential. Laparoscopic sleeve gastrectomy is an effective treatment for obesity and its related comorbidities in both adolescents and adults.

Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing

2006 ◽  
Vol 121 (4) ◽  
pp. 329-332 ◽  
Author(s):  
V Nakhla ◽  
Y M Takwoingi ◽  
A Sinha
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Approach ◽  
Suitable Alternative ◽  
Significant Difference ◽  
Study Population ◽  
The Mean ◽  
Gauze Pack

Objectives: To assess the myringoplasty graft take rate, comparing two methods of post-operative ear packing: bismuth iodoform paraffin paste (BIPP) gauze versus tri-adcortyl ointment (TAO).Methods: A retrospective study of patients who had undergone myringoplasty at our department within a three-year period was undertaken. Data, including age, site and size of perforation, grade of surgeon, surgical approach, use of post-operative ear dressings, complications, and audiometric outcome, were collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at six months) was noted.Results: One hundred and seventy myringoplasties were performed over the study period, but data were complete on 154 patients and these constituted the study population. Age ranged from nine to 71 years (mean age 34 years) and the mean follow-up period was seven months. Consultants performed 62 per cent of the operations, with an 85 per cent success rate, whereas trainees performed the remaining 38 per cent, with a success rate of 73 per cent (p=0.059). The overall success rate was 80 per cent; 79 per cent for BIPP and 83 per cent for TAO (p=0.55), and 87 per cent for small perforations and 75 per cent for subtotal perforations (p=0.22). There was audiometric improvement in 74 per cent of cases.Conclusion: We found no significant difference in outcome between patients packed with TAO and BIPP. Packing with TAO is therefore a suitable alternative to BIPP gauze ear dressing following myringoplasty.

scholarly journals Management of sleeve gastrectomy leakage with endoscopic stenting

2019 ◽  
Vol 6 (3) ◽  
pp. 824 ◽  
Author(s):  
Fadli Dogan ◽  
Mürsit Dincer
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Obesity Surgery ◽  
Endoscopic Stenting ◽  
The Mean ◽  
Stapler Line ◽  
Experienced Endoscopists ◽  
Demographic Features

Background: Sleeve gastrectomy is one of the most commonly applied procedures for obesity surgery. Leakage from the stapler line and bleeding are the most important complications of sleeve gastrectomy. This study aimed to report the results of esophageal stent procedure applied to cases who developed leaks after sleeve gastrectomy.Methods: This study included patients who had sleeve gastrectomy due to morbid obesity and were detected to have a leak after the procedure. Demographic features, time of leakage after the surgery, and the management of the leak were analyzed.Results: it was detected in this study, 1220 cases who had sleeve gastrectomy for morbid obesity. Leaks were developed in 10 patients after Laparoscopic Sleeve Gastrectomy (LSG). Four patients, followed conservatively without stent application, were excluded. Six patients, treated with stent application, were included. Two of the patients were males, and four were females (M/F=1/2). The mean age was 38.3 (±11.57) (range: 26-58). The mean body mass index was 43.26 (±2.10)kg/m2. The incidence of a leak was 0.81%.Conclusions: In a conclusion, stents can be safely applied by experienced endoscopists for the management of sleeve gastrectomy leakage.

Ocular dermoids in 13 cats: a multicentre retrospective study

2021 ◽  
pp. 1098612X2110438
Author(s):  
Anaïs Cathelin ◽  
Anne-Sandrine Augsburger ◽  
Jennifer Anne ◽  
Sylvain Medan ◽  
Julien Michel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ocular Surface ◽  
Rare Condition ◽  
Surgical Excision ◽  
Genetic Transmission ◽  
Study Population ◽  
The Mean ◽  
Lost To Follow Up ◽  
Multicentre Retrospective Study

Objectives The aim of this multicentre retrospective study was to review the clinical data, outcomes and histopathological features of cats that had been treated for ocular surface dermoids. Methods Thirteen cats from various private practices in France with a clinical diagnosis of ocular surface dermoid were included in the study. Results The mean age of the study population at the time of diagnosis was 5 months. There were nine males and four females. Three different breeds were, including: domestic shorthair (n = 7), Birman (n = 4) and Havana Brown (n = 2). Two of the four Birmans were related (same sire). The two Havana Browns were also related (same sire). All of the dermoids were unilateral. Five of the dermoids were strictly conjunctival. Four affected both the conjunctiva and the cornea. Three affected both the conjunctiva and the eyelid, and one was strictly corneal. They were located in various positions: temporal (n = 9), inferonasal (n = 1), dorsonasal (n = 1) and dorsotemporal (n = 1). The last dermoid was heterogeneous and involved the nasal, dorsal and temporal quadrants. Concurrent eye diseases were observed in five patients: four cats exhibited associated eyelid agenesis and one cat exhibited persistent iris-to-iris pupillary membranes. Ten dermoids were surgically excised with no recurrences. Surgery was not performed for three cats: one cat died a few days after diagnosis and two cats were lost to follow-up after initial presentation. Conclusions and relevance Ocular surface dermoids are a rare condition in cats that can be treated successfully by surgical excision. Although our study reports only a small number of cases, the observation of ocular surface dermoids in two related cats in two different breeds indicates that genetic transmission is likely.

scholarly journals Decision Regret after Laparoscopic Sleeve Gastrectomy—5 Years’ Perspective

2021 ◽  
Author(s):  
Katarzyna Bartosiak ◽  
Michał R. Janik ◽  
Piotr Kowalewski ◽  
Maciej Walędziak ◽  
Andrzej Kwiatkowski
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Negative Correlation ◽  
Telephone Survey ◽  
Significant Negative Correlation ◽  
Decision Regret ◽  
The Mean

Abstract Introduction Patient's satisfaction after weight loss surgery is in the research spotlight. However, there are still no quantitative data regarding whether patients regret their decision to undergo laparoscopic sleeve gastrectomy (SG). Objectives The present study aimed to evaluate whether patients regret their decision to undergo SG 5 years after surgery. The secondary objective was to identify whether weight loss and a higher quality of life (QoL) score correlate with the regret expressed by patients. Setting Military Hospital, Poland Methods A telephone survey was carried out among patients 5 years after surgery. Patient satisfaction regarding their decision to undergo SG was assessed using the Decision Regret Scale. QoL scores were determined using the 36-Item Short Form Survey (SF-36). Results One hundred and four patients who answered a full telephone survey were enrolled in the study. Change in body mass index (ΔBMI) was 12.31±6.2, excess body mass index loss (%EBMIL) was 55.45%±25.52%, and percent total weight loss (%TWL) was 25.20%±11.7%. At the 5-year postoperative telephone survey, the mean general health score was 50.96±14.0 and the mean regret score was 32.33±13.24 (range, 25–85). A statistically significant negative correlation was observed between %EBMIL and regret score (r=−0.435; p<0.001). There was a significant negative association between regret score and energy/fatigue QoL (r=−0.205; p=0.040). Only eight patients (7.69%) scored >50 on the Decision Regret Scale, which was considered to represent overall regret for their decision. Conclusion Our study suggests that, in general, patients did not regret their decision to undergo SG. Key Points The majority of patients did not regret their decision to undergo SG. There was a statistically significant negative correlation between weight loss and patients’ feelings of regret. Energy/fatigue QoL was the strongest correlate of whether patients regretted their decision to undergo SG. Graphical Abstract

scholarly journals Impact of Resected Gastric Volume on Postoperative Weight Loss after Laparoscopic Sleeve Gastrectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Stefano D’Ugo ◽  
Vittoria Bellato ◽  
Emanuela Bianciardi ◽  
Paolo Gentileschi
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Potential Role ◽  
Gastric Volume ◽  
Specimen Size ◽  
Postoperative Weight Loss ◽  
The Mean

Among the bariatric surgery community, it has recently emerged the idea of a possible association between resected gastric volume (RGV) and weight loss after laparoscopic sleeve gastrectomy (LSG). If the size of the sleeve depends on the bougie caliber, the resected volume of the stomach remains something which is not possible to standardize. The aim of the study was to investigate a possible relationship between RGV and weight loss after LSG. We developed a mathematical method to calculate the RGV, based on the specimen size removed during LSG. Ninety-one patients (63 females and 28 males) affected by morbid obesity were included in the study. They underwent LSG between 2014 and 2016. Mean preoperative BMI was 45±6.4. At 1 year after LSG, the mean BMI was 30±5.3 and the EWL% was 65±20.2. The statistical analysis of RGV, BMI, and EWL% at 1-year follow-up did not find any correlation between the volume of stomach removed and the weight loss after LSG. Further studies in the future should clarify the potential role of RGV during LSG. This trial is registered with ClinicalTrials.gov NCT03938025.

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