scholarly journals Surgical Treatment of Clinically Significant Reactive Hypoglycemia Nesidioblastosis, Post-Gastric Bypass

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Keshishian Ara ◽  
Rajtar Malgorzata ◽  
Rosado Miguel
Keyword(s):  
Gastric Bypass ◽  
Surgical Treatment ◽  
Reactive Hypoglycemia ◽  
Clinically Significant

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

scholarly journals Surgical treatment of peripheral hepatic cholangiocarcinoma with a visceral vein invasion

2020 ◽  
Vol 87 (7-8) ◽  
pp. 3-9
Author(s):  
О. Yu. Usenko ◽  
О. V. Hrynenko ◽  
А. І. Zhylenko ◽  
О. О. Popov ◽  
А. V. Husiev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Resection ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Late Results ◽  
Peripheral Cholangiocarcinoma ◽  
Group A ◽  
Comparative Group ◽  
Biliary Ducts ◽  
Clinically Significant

Objective. To estimate the immediate and late results of surgical treatment in patients, suffering peripheral cholangiocarcinoma with invasion of visceral vein. Маterials and methods. Retrospective analysis was accomplished for surgical treatment of 84 patients, suffering peripheral cholangiocarcinoma, in whom radical operations were performed in Department of Transplantation and Hepatic Surgery of Shalimov National Istitute of Surgery and Transplantology in a period from Jan. 2004 tо Dec. 2018 yrs. The investigated group consisted of 28 patients, to whom hepatic resection with simultant resection and plasty of visceral veins for tumoral vascular invasion was performed. Into comparison group 56 patients were included, in whom hepatic resection was not accompanied with vascular resection. Results. Trustworthy differences were absent between groups in accordance to following indices: the patients’ age (p=0.16-0.7), gender (p=0.3), physical status (p=0.36), pre- and postoperative stationary stay (p=0.4). In the investigated group there were performed 14.3% hemihepatectomies, 32.1% extended hemihepatectomies and 53.6% threesectioectomies, and in a comparative one - 57.2% (р ≤ 0.001), 14.3% (р = 0.054) and 21.4% (р = 0.002), accordingly. Simultant intervention on biliary ducts was done in 37.5% patients from investigated group and in 25% patients from comparative group (р = 0.305), the adjacent organs resection - in 14.3 and 12.5% (р = 0.819) patients, accordingly. Clinically significant postoperative complications were observed in 25 and 30.4% (р = 0.262) patients, accordingly. In the investigated group postoperative mortality was absent, while in a comparative one it constituted 3.5%. In the investigated group a 3-years and a 5-years total survival was noted in 47 and 35% patients, accordingly, while in a comparison group - in 49% (р = 0.317) and 38% (р = 0.003) patients, accordingly. In investigated group a 3-years and a 5-years survival without a recurrence was noted in 39 and 28% patients, accordingly, and in a comparative group - in 44% (р = 0.04) and 31% (р=0.002) patients, accordingly. Conclusion. Іnvasion of peripheral cholangiocarcinoma into visceral veins does not constitute a contraindication for operative treatment, if it is conducted in a highly specialized multidisciplinary centre.

Catastrophic UGI bleed in gastric bypass patients from ulcer erosion into the splenic artery: details of rapid surgical treatment

2015 ◽  
Vol 11 (6) ◽  
pp. S114
Author(s):  
Brian Lane ◽  
Amy Biedenbach ◽  
Aaron Bolduc ◽  
Sean Lee ◽  
Nora Burkart ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Surgical Treatment ◽  
Splenic Artery

scholarly journals Su2038 – What Defines Clinically Significant Weight Regain After Roux-En-Y Gastric Bypass for Patients with Hypertension?

2019 ◽  
Vol 156 (6) ◽  
pp. S-1456-S-1457
Author(s):  
Kelly Hathorn ◽  
Pichamol Jirapinyo ◽  
Ahmad Najdat Bazarbashi ◽  
Walter W. Chan ◽  
Christopher C. Thompson
Keyword(s):  
Gastric Bypass ◽  
Weight Regain ◽  
Clinically Significant

ON SURGICAL TREATMENT OF PATIENTS WITH VERTEBROBASILAR INSUFFICIENCY ASSOCIATED WITH KIMMERLE ANOMALY

2005 ◽  
pp. 069-073
Author(s):  
Aleksandr Kuzmich Chertkov ◽  
Maksim Evgenyevich Klimov ◽  
Marina Valentinovna Nesterova
Keyword(s):  
Surgical Treatment ◽  
Basilar Artery ◽  
Intraoperative Monitoring ◽  
Diagnostic Algorithm ◽  
Differential Diagnostics ◽  
Vertebrobasilar Insufficiency ◽  
Study Objective ◽  
Vertebral Arteries ◽  
Clinically Significant ◽  
A New Technique

Patients with vertebrobasilar insufficiency, which are frequent in neurological and neurosurgical practice, require a complex examination to reveal its ethiology and to perform a differential diagnostics. The study objective was to develop a diagnostic algorithm for detection of clinically significant forms of Kimmerle anomaly, and to introduce a new technique for surgical treatment under intraoperative monitoring of the vertebral artery decompression. When a patient with the Kimmerle anomaly shows a vertebrobasilar insufficiency, a comprehensive surgical policy includes a complex clinicalphysiological assessment of the vertebrobasilar basin (from vertebral arteries entrances up to the basilar artery and its branches). If any other pathology is excluded, the Kimmerle rings (foramen arcuale) are removed and hemodynamics in the vertebrobasilar basin is estimated by clinical and graphical Doppler methods.

scholarly journals Continuous Glucose Monitoring for Evaluation of Glycemic Excursions after Gastric Bypass

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Florencia Halperin ◽  
Mary Elizabeth Patti ◽  
Megan Skow ◽  
Muhammad Bajwa ◽  
Allison B. Goldfine
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Rare Complication ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Hyperinsulinemic Hypoglycemia ◽  
History Of ◽  
Clinically Significant ◽  
Asymptomatic Subjects ◽  
Tolerance Testing

Background. Hyperinsulinemic hypoglycemia with neuroglycopenia is a rare complication of Roux-en-Y gastric bypass (RYGB). We hypothesized that continuous glucose monitoring (CGM) would be useful to characterize glycemic variability after RYGB.Methods. CGM and mixed meal tolerance testing (MMTT) were performed on sixteen post-RYGB subjects, ten with a history of neuroglycopenia on medical treatment and six asymptomatic controls.Results. 9 of 10 subjects with neuroglycopenia developed hypoglycemia defined by glucose <70 mg/dL on CGM, and 3 of 9 on MMTT. In asymptomatic subjects, 3 of 6 had asymptomatic hypoglycemia during CGM, and 3 of 5 on MMTT. Therefore, the sensitivity and specificity to detect clinically significant hypoglycemia was 90% and 50% for CGM and 33% and 40% for MMTT.Conclusions. Asymptomatic hypoglycemia after RYGB is more frequent than commonly recognized. For clinicians evaluating patients for postbypass neuroglycopenia, CGM may be a valuable diagnostic tool.

Refractory Gastroparesis After Roux-en-Y Gastric Bypass: Surgical Treatment with Implantable Pacemaker

2007 ◽  
Vol 11 (12) ◽  
pp. 1669-1672 ◽  
Author(s):  
J. R. Salameh ◽  
Robert E. Schmieg ◽  
J. Matt Runnels ◽  
Thomas L. Abell
Keyword(s):  
Gastric Bypass ◽  
Surgical Treatment ◽  
Implantable Pacemaker
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