Foregut Issues After Bariatric Surgery

2022 ◽  
pp. 263451612110674
Author(s):  
Fareed Cheema ◽  
Aurora D. Pryor
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Postoperative Complications ◽  
Weight Loss Surgery ◽  
Long Term Outcomes ◽  
Operative Complications ◽  
Complications After Bariatric Surgery ◽  
Broad Scale ◽  
Post Operative Complications

Weight loss surgery has overall been shown to be very safe and effective. However, long-term outcomes data has allowed codification of post-operative complications specific to the type of weight loss surgery performed. This review focuses specifically on foregut-related postoperative complications after weight loss surgery, most of which are not discussed on a broad scale in the literature yet whose prevalence continues to rise. Clinicians should maintain a broad differential when treating patients with complications after bariatric surgery in order to perform a thorough and precise workup to identify the diagnosis and guide management.

553: Pregnancy reduces initial weight loss after bariatric surgery but does not influence long-term outcomes

2014 ◽  
Vol 210 (1) ◽  
pp. S273
Author(s):  
Thu Quyên Pham ◽  
Philippe Deruelle ◽  
Marie Pigeyre ◽  
Eric Loridan ◽  
Julien Couster ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Initial Weight ◽  
Long Term Outcomes ◽  
Initial Weight Loss

scholarly journals Study of early post-operative complications in relation to nature of anaesthesia and type of surgery

2018 ◽  
Vol 5 (8) ◽  
pp. 2827
Author(s):  
Irfan Parvez Qureshi ◽  
Saima Qureshi ◽  
Vimal Modi
Keyword(s):  
Postoperative Complications ◽  
General Anaesthesia ◽  
Large Scale ◽  
Tertiary Care ◽  
Anaesthetic Management ◽  
Major Surgery ◽  
Operative Complications ◽  
Type Of Surgery ◽  
Post Operative Complications

Background: Many people have complications after surgery; some transient, others serious, but all are important to patients. The likelihood of postoperative complications is influenced by the type of surgery, the patients pre-existing comorbid state and perioperative management. Anaesthesia result in a variety of metabolic and endocrine responses, but conventional wisdom maintains that anaesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on contrary, anaesthetic management may in fact exert a number of longer-term effects in postoperative outcome.Methods: A prospective study of early post-operative complication in 100 patients’, who underwent major surgery, was done in the Department of Surgery in a tertiary care teaching hospital, Indore. Therefore, the present study was carried out prospectively to study the incidence of postoperative complications in relation to age, sex and other factors which influence them and correlation of post-operative complications with the nature of anaesthesia, duration of operation, type of surgery and in surgery above diaphragm or below diaphragm.Results: The incidence of post-operative complications was more in patients operated with general anaesthesia (48.38% and 12.9% respectively) the morbidity and mortality in patients who were operated under spinal anaesthesia was lower than general anaesthesia, but morbidity was higher in patients who were operated under epidural anaesthesia, but mortality was lower than epidural.Conclusions: There is accumulating evidence that anaesthetic management may indeed exert a number of influences on longer term postoperative outcomes. Further prospective, randomized, large scale, human trials with long- term follow-up are required to clarify the association between anaesthesia technique and postoperative outcome.

scholarly journals Bariatric surgery proves long-term benefit in patients with cirrhosis

2020 ◽  
Author(s):  
Manhal Izzy ◽  
Mounika Angirekula ◽  
Barham K Abu Dayyeh ◽  
Fateh Bazerbachi ◽  
Kymberly D Watt
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Descriptive Analysis ◽  
Total Body Weight ◽  
Hepatitis C Infection ◽  
Long Term Outcomes ◽  
Hepatic Decompensation ◽  
Compensated Cirrhosis

Abstract Background Obesity is commonly observed in patients with cirrhosis, especially with the increasing prevalence of non-alcoholic steatohepatitis (NASH). Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk; therefore, data are lacking regarding long-term outcomes. In this study, we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric surgery. Methods We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23, 2009 and November 9, 2011, and followed in a pilot study for evaluation of bariatric surgery outcomes. Only patients with more than 4 years of follow-up were included in the analysis. Data regarding their liver disease, metabolic status, and survival were collected. A descriptive analysis was performed. Results The cohort consisted of 10 patients, of whom 7 were females. The median post-surgical follow-up was 8.7 years (± 1.4 years). All patients had biopsy-proven NASH; two patients had concurrent, untreated hepatitis C infection. During the observation period, there was a mean weight loss of 24 kg (19.2% of total body weight pre surgery, P < 0.001) and only one patient regained weight to the baseline pre-surgical measurement. One patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later died. The remainder of the patients did not have any hepatic decompensation, cardiovascular event, or mortality. Except for one patient with Gilbert syndrome, bilirubin was normal in all patients at last follow-up. Conclusions Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-term follow-up.

scholarly journals TP9.2.8Conservative versus surgical management of complicated diverticulitis - a retrospective study of long-term outcomes

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Emily Durrity ◽  
Grace Elliott ◽  
Tabitha Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Long Term Outcomes ◽  
Stoma Reversal ◽  
Operative Complications ◽  
Group A ◽  
Grade 3 ◽  
Group B ◽  
Post Operative Complications

Abstract Introduction The management of complicated diverticulitis has evolved over the years, with a shift towards a conservative approach. The aim of this study was to evaluate the feasibility and long-term outcomes of conservative management of an episode of complicated diverticulitis. Method We retrospectively evaluated patients presenting with perforated colonic diverticulitis between 2013 and 2017. Demographic, presentation and management data was recorded. CT grading system and Clavien-Dindo classification of complications was used. Results Ninety-two patients were included, with a male-to-female ratio of 1:2. Forty patients had a Hartmann’s procedure on the first admission (Group A), the remaining 52 patients were managed conservatively with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 65% of Group A and in 40.4% of Group B patients. 14 (26.9%) patients re-presented with recurrent diverticulitis in Group B, 12 (23.1%) of whom required surgical resection in the course of follow-up. Group A had significantly increased morbidity and poorer outcomes compared to Group B with a longer median length of stay (23.5 vs 10.2 days). Post-operative complications affected 72.5% (29 patients), with 40% being grade III or higher. Stoma reversal was performed in 10 (25.8%). Conclusion In carefully selected cases, complicated diverticulitis including CT grade 3 and 4, can be managed conservatively with acceptable rates of recurrence. Better overall outcomes were observed compared to surgical intervention, which is associated with high rates of post-operative complications (72.5%) and low stoma reversal rates 25.8%.

scholarly journals Risk stratification score to determine long-term outcomes based on post-operative complications following cardiac surgery -- need of the hour?

2021 ◽  
Author(s):  
Siddharth Pahwa
Keyword(s):  
Risk Stratification ◽  
Risk Model ◽  
Cardiac Surgical Procedures ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Risk Algorithm ◽  
Operative Complications ◽  
Risk Stratification Score ◽  
Post Operative Complications

Risk models were developed to provide clinicians and hospitals with a tool to evaluate risk-adjusted outcomes and to guide quality improvement. The Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM) is the most commonly used risk algorithm, others being the EuroSCORE logistic and additive algorithm and the Ambler Risk Score. These models utilize pre-operative patient characteristics to predict operative risk and early outcomes. Although a great deal of effort has gone into models to predict short-term patient outcomes after common cardiac operations, there has been relatively little effort to develop a statistical algorithm to predict long-term outcomes. Moreover, no risk model takes into account early post-operative complications to construct an algorithm to predict long-term outcomes. The formulation of a risk stratification score based on post-operative complications following common cardiac surgical procedures may be used to estimate the likelihood of long-term survival for individual complications, as well as various permutations and combinations of complications. This may have profound implications in devising strategies to prevent the most devastating combination of complications. Also, this may assist in informing patients and families of the predicted survival after a particular complication or a combination of complications. As Dokollari et all pointed out, there is impetus towards the direction of formulating a risk stratification score, and this may indeed be the need of the hour.

scholarly journals Redo pull-through in total colonic aganglionosis due to residual aganglionosis: a single center’s experience

2020 ◽  
Author(s):  
Jia-Yu Yan ◽  
Chun-Hui Peng ◽  
Wen-Bo Pang ◽  
Yong-Wei Chen ◽  
Cai-Ling Ding ◽  
...  
Keyword(s):  
Bowel Function ◽  
Good Growth ◽  
Initial Operation ◽  
Long Term Outcomes ◽  
Total Colonic Aganglionosis ◽  
Telephone Interviews ◽  
Operative Complications ◽  
Pull Through ◽  
Post Operative Complications

Abstract Background Reoperation for total colonic aganglionosis (TCA) may be required for residual aganglionosis after an initial radical operation. We aimed to investigate the symptoms, management, and outcomes of patients who required a redo pull-through (Redo PT). Methods Nine TCA patients underwent Redo PT at our center between 2007 and 2017. Their medical records were reviewed. Parental telephone interviews that included disease-specific clinical outcomes were conducted, and post-operative complications and long-term outcomes (including height-for-age/weight-for-age and bowel-function score) were compared to those of single-pull-through (Single PT) patients (n = 21). Results All the nine Redo PT patients suffered obstruction within 1 month after the initial operation that could not be alleviated by conservative treatment. All abdominal X-ray/contrast barium enemas showed proximal bowel dilatation, indicating residual aganglionosis. The median ages at the initial operation and Redo PT were 200 and 509 days, respectively. Reoperation consisted of an intraoperative frozen biopsy and a modified laparotomic Soave procedure in all patients. Post-operative complications included perianal excoriation (n = 3), intestinal obstruction (n = 2), enterocolitis (n = 2), and rectovestibular fistula (n = 1). Seven Redo PT patients were followed up for a mean time of 7.1 ± 2.3 years; six (85.7%) had good growth and four (57.1%) had good bowel-function recovery. Post-operative complications and long-term outcomes were almost equal between the Redo PT and Single PT groups (all P > 0.05). Conclusion TCA patients with recurrent obstructive symptoms and dilated proximal bowel may have residual aganglionosis after an initial operation. Redo PT is effective and provides good long-term outcomes comparable to those of patients who benefited from Single PT.

Telenutrition: An Integrated Approach to Delivering Medical Nutrition Therapy to Bariatric Surgery Patients via Synchronous Teleconsultation

2014 ◽  
Vol 7 (2) ◽  
pp. 169-174
Author(s):  
Dorothy Roedel Ferraro
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Patient Adherence ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Long Term Outcomes ◽  
Bariatric Patients ◽  
Improve Patient ◽  
Medical Nutrition

Bariatric surgery has emerged as a safe and effective means to substantial weight loss with subsequent resolution of comorbid conditions, improvement in quality of life, and increased longevity for the morbidly obese. Achieving significant and sustained weight loss following surgery requires lifelong dietary and behavior modifications. Bariatric patients are challenged to adhere to the postoperative plan and the clinician to provide the necessary support services to promote the patient’s adherence. Long-term outcomes rely on lifelong patient adherence and follow-up care. Dietary management is central to weight loss, and medical nutrition therapy (MNT) provides the patient with the knowledge and skills needed to modify dietary behaviors. Telenutrition offers a novel and innovative approach to nutritional counseling for bariatric patients who might otherwise have limited or no access. This article presents the use of synchronous teleconsultation to augment patient care following bariatric surgery by connecting patients with the registered dietitian through web conferencing. The objectives of this multicomponent telenutrition program are to improve patient access to MNT, augment clinician–patient interaction between office visits, increase patient satisfaction, and improve patient adherence to prescribed treatment plans, thereby optimizing both short- and long-term outcomes following bariatric surgery.

Mo1185 Long-Term Outcomes of Weight Loss Surgery for Obesity in a Community Setting: Gastric Bypass Versus Adjustable Banding?

2012 ◽  
Vol 142 (5) ◽  
pp. S-615
Author(s):  
Nam Q. Nguyen ◽  
Philip A. Game ◽  
Justin Bessell ◽  
Carly M. Burgstad ◽  
Tamara L. Debreceni ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Loss Surgery ◽  
Community Setting ◽  
Long Term Outcomes ◽  
Surgery For Obesity ◽  
Adjustable Banding
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