Small Bowel Obstruction Publications (17043)


Small Bowel Obstruction Publications

Surgery 2017 Jan 19. Epub 2017 Jan 19.
Henry Ford Wyandotte Hospital, Wyandotte, MI. Electronic address:
Cir Cir
Cir Cir 2017 Jan 19. Epub 2017 Jan 19.
Servicio de Cirugía General, Hospital Regional «Puebla», Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE, Puebla, México.

Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. Read More

A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia. During her prolonged hospital stay she presented an intestinal obstruction. The diagnosis of gallstone ileus was made by CT scan. Despite surgical treatment, she died due to late diagnosis.
Gallstone ileus is a rare pathology, difficulty in diagnosis prolongs hospital stay, which directly influences mortality.

Transpl. Int.
Transpl Int 2017 Jan 21. Epub 2017 Jan 21.
University of Cambridge Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.
Obes Surg
Obes Surg 2017 Jan 20. Epub 2017 Jan 20.
Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Laparoscopic adjustable gastric band (LAGB) carries a high rate of failure and reoperation. Laparoscopic conversion of failed LAGB to Roux-en-Y gastric bypass (RYGB) has been shown to be safe and feasible, but long-term follow-up data is still limited.
The aim of this study is to evaluate the safety and effectiveness of RYGB after failed LAGB in our patient population. Read More

The setting was the University Hospital, Beirut, Lebanon.
Using a prospectively collected database, we retrospectively reviewed data of patients who underwent LAGB revision to RYGB at our institution between 2006 and 2014.
A total of 58 patients underwent RYGB after failed LAGB in our institution between 2006 and 2014. Of those, 20 patients (34.5%) had concomitant band removal while the rest underwent a two-stage RYGB after a mean of 30 months after band removal. A follow-up was achieved in 84.5, 82, 83, 95, and 76% of patients at 1, 2, 3, 4, and 5 years after RYGB. Percentage of excess weight loss (%EWL) was 62.8, 68.1, 64.2, 63.8, and 61.3% at 1, 2, 3, 4, and 5 years, respectively, while percentage of total weight loss (%TWL) was 28.4, 30.7, 29.4, 28.9, and 28.6% at the corresponding time periods. The most common short-term complications were abscesses/leaks (5.2%) while the most common long-term complications were symptomatic gallstones necessitating laparoscopic cholecystectomy (5.2%), incisional hernias (5.2%), and small-bowel obstruction (3.4%). No surgery-related mortality was recorded.
RYGB is a safe procedure with favorable weight loss outcomes at 5 years and can be considered a good rescue procedure after failed LAGB.

Female Pelvic Med Reconstr Surg
Female Pelvic Med Reconstr Surg 2017 Jan 18. Epub 2017 Jan 18.
From the *Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA; and †Division of Urogynecology, Department of Obstetrics & Gynecology, West Penn Hospital, Pittsburgh, PA.

Warm-up is defined as a preparatory activity or procedure. Using case order as a surrogate for surgeon warm-up, first cases were compared with second or later cases for intraoperative complications, operative time, and length of stay (LOS) among women undergoing laparoscopic sacrocolpopexy.
This is a retrospective study of laparoscopic sacrocolpopexies performed from 2009 through 2014 at a large academic center. Read More

Any surgery preceding laparoscopic sacrocolpopexy was considered a surrogate for surgeon warm-up. Logistic and linear regression analyses were used to identify predictors of complications, operative time, and LOS.
Of 480 procedures, 192 (40%) were first cases and 288 (60%) were second or later. Baseline characteristics were similar between groups. Intraoperative complication rate was not different between groups (6.3% vs 3.1%, P = 0.50) even after controlling for risk factors. Operative times were comparable on initial analysis (231.2 ± 55.2 vs 225.9 ± 51.2 minutes, P = 0.28l), but a small difference was detected after adjusting for confounding factors (body mass index, menopausal status, surgeon experience, intraoperative complications, and concomitant hysterectomy or midurethral sling; adjusted β = 8.44 minutes, P = 0.037). Length of stay was longer for first case patients (1.44 ± 0.67 vs 1.24 ± 0.50 days, P < 0.001) even after adjusting for age, medical comorbidities, operative time, conversion to laparotomy, ileus/bowel obstruction, and postoperative urinary retention (adjusted β = 0.183 days, P = 0.001) as well as after accounting for delayed start time of second or later cases.
Laparoscopic sacrocolpopexy performed first case of the day without preoperative surgeon warm-up conferred no significant increase in intraoperative complications. Second or later cases were associated with small decreases in operative time and in LOS.

J Minim Invasive Gynecol
J Minim Invasive Gynecol 2017 Jan 16. Epub 2017 Jan 16.
Women's Health Division, University College London Hospital, 250 Euston Road, London NW1 2PG, United Kingdom. Electronic address:

To review surgical outcomes and histopathological findings following laparoscopic myomectomy by a team at a university teaching hospital.
This was a retrospective review of consecutive cases of laparoscopic myomectomy carried out by members of our minimal access surgery team between January 2004 and December 2015.
Canadian Task Force Classification II-3 SETTING: University Teaching Hospital PATIENTS: Women undergoing laparoscopic myomectomy INTERVENTIONS: Laparoscopic myomectomy MEASUREMENTS AND MAIN RESULTS: We collected women's demographic data, clinical histories and surgical outcomes, including complication rates and the incidence of undiagnosed uterine malignancy. Read More

514 women were booked for laparoscopic myomectomy during the study period. 512/514 [99.6% (95% CI 99.05 - 100.15)] of procedures were successfully completed. Two cases were converted to open surgery: one because of suspected uterine malignancy and another due to bowel injury at initial entry. The median number of myomas removed at laparoscopy was one (range 1 12, mode of 1). The median size of the largest myoma removed at each procedure was 70mm (range 10 - 200 mm), as assessed subjectively by the operating surgeon. The median blood loss was 73ml (range 5 to 3000ml. The median length of stay in hospital was 2 nights (range 0-24 nights). Breach of the uterine cavity occurred in 50/514 [9.7% (95% CI 7.17 - 12.29)] of cases. Electro-mechanical morcellation was used in 496/514 [96.5% (95% CI 94.9 - 98.1)] of patients. 18/514 [3.5% (95% CI 1.91 - 5.09)] women suffered significant complications: blood loss >1000ml (n=15), bowel injury (n=1), bladder injury (n=1), small bowel obstruction secondary to port site hernia (n=1). There were no cases of undiagnosed uterine malignancies following myoma morcellation.
Laparoscopic myomectomy can be conducted with a low rate of major complications and, in our experience, the chance of discovering occult malignancy is very low.

Transplant. Proc.
Transplant Proc 2017 Jan - Feb;49(1):210-212
Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Transplant. Proc.
Transplant Proc 2017 Jan - Feb;49(1):135-138
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Patients with intestinal failure (IF) are candidates for intestinal transplantation (ITx). In Japan, these patients have few opportunities to undergo cadaveric ITx because of low rates of organ donation. The donor criteria and recipient priority for ITx are still unknown. Read More

We reviewed our cases of IF to investigate which patients should be prioritized for ITx.
Patients with IF who were registered as candidates for cadaveric ITx between January 2010 and November 2015 in our institute were included in this retrospective study. Their data were gathered from their charts and analyzed.
Five patients were included. Their primary diseases included total colon aganglionosis (n = 1), chronic idiopathic intestinal pseudo-obstruction syndrome (n = 2), superior mesenteric vein embolization (n = 1), and graft loss after ITx (n = 1). Two patients died of liver failure (LF) during the waiting period. The remaining three are now alive and waiting for transplantation. The lengths of the remaining intestine were more than 20 cm in living cases but less than 20 cm in fatal cases. In the fatal cases, they had several episodes of catheter-related blood stream infection, which caused LF and acute renal failure.
We identified two patients with less than 20 cm residual small bowel who died after acute deterioration of liver function. Patients with ultra-short bowel could have a higher risk of LF. Therefore, they should be referred as soon as possible to a specialized hospital where ITx is a choice of treatment for IF.