Publications by authors named "Carolina Vanetta"

7 Publications

  • Page 1 of 1

Diabetes remission after bariatric surgery.

World J Diabetes 2021 Jul;12(7):1093-1101

Department of Surgery, Duke University, Durham, NC 27705, United States.

Over the last decade, obesity rates have continued to rise in the United States as well as worldwide and are showing no signs of slowing down. This rise is in parallel with the increasing rates of type 2 diabetes mellitus (T2DM). Given the association between obesity and T2DM and their strong correlation with increased morbidity and mortality in addition to healthcare expenditure, it is important to recognize the most effective ways to combat them. Thus, we performed a review of literature that focused on assessing the outcomes of T2DM following bariatric surgery. Available evidence suggests that bariatric surgery provides better T2DM resolution in obese patients when compared to best medical management alone. Additionally, Biliopancreatic diversion with duodenal switch as well as Roux-en-Y gastric bypass have demonstrated higher rates of T2DM resolution when compared with other bariatric procedures.
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http://dx.doi.org/10.4239/wjd.v12.i7.1093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311476PMC
July 2021

Comment on: Unequal rates of postoperative complications in relatively healthy bariatric surgical patients of White and Black race.

Surg Obes Relat Dis 2021 09 15;17(9):e36-e37. Epub 2021 May 15.

Division of Metabolic and Weight Loss Surgery, Duke University, Durham, North Carolina.

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http://dx.doi.org/10.1016/j.soard.2021.05.013DOI Listing
September 2021

Liver graft procurement in neurologically deceased donor: Hospital Italiano of Buenos Aires approach.

Hepatobiliary Pancreat Dis Int 2021 Apr 28. Epub 2021 Apr 28.

Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Section of HPB Surgery & Liver Transplantation Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

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http://dx.doi.org/10.1016/j.hbpd.2021.04.009DOI Listing
April 2021

Role of laparoscopy in the treatment of internal biliary fistulas in a high-volume center and a review of the literature.

Surg Endosc 2021 Mar 31. Epub 2021 Mar 31.

Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABH, Buenos Aires, Argentina.

Background: Biliary fistulas may result as a complication of gallstone disease. According to their tract, abdominal internal biliary fistulas may be classified into cholecystobiliary and bilioenteric fistulas. Surgical treatment is challenging and requires highly trained surgeons with high preoperative suspicion. Conventional surgery is still of choice by most of the authors. However, laparoscopy is emerging as a minimally invasive alternative. We investigated the surgical approach, conversion rate, and outcomes according to the type of biliary fistula.

Methods: We retrospectively reviewed 11,130 laparoscopic cholecystectomies, 31 open cholecystectomies, and 31 surgeries for gallstone ileus at our institution from May 2007 to May 2020. We diagnosed internal biliary fistula in 73 patients and divided them into two groups according to their fistulous tract: cholecystobiliary fistula and bilioenteric fistula. We described demographic characteristics, preoperative imaging modalities, surgical approach, conversion rates, surgical procedures, and outcomes. We additionally revised the literature and compared our results with 13 studies from the past 10 years.

Results: There were 22 and 51 patients in the cholecystobiliary and bilioenteric groups, respectively. Our preoperative suspicion of a fistula was 80%. We started 88% of procedures by laparoscopic approach. The effectiveness of laparoscopy in the resolution of internal biliary fistula was 40% for cholecystobiliary fistula and 55% for bilioenteric fistulas. The most frequent cause for conversion to laparotomy was the difficulty to identify anatomical features, in addition to the need to perform a Roux en-Y hepaticojejunostomy. Choledocholithiasis was not associated with an increase in conversion rates.

Conclusions: Laparoscopic resolution of a biliary fistula is still a matter of controversy. Despite the high conversion rates, we believe that a great number of patients benefit from this minimally invasive technique. A high preoperative suspicion and trained surgeons are vital in the treatment of internal biliary fistulas.
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http://dx.doi.org/10.1007/s00464-021-08459-1DOI Listing
March 2021

[Endovascular treatment of incidental and emergency splenic aneurysm].

Medicina (B Aires) 2021 ;81(1):96-98

Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

True splenic aneurysms are saccular dilations of all the layers of the splenic artery, more common in women, pregnancy and portal hypertension. They are usually asymptomatic and diagnosed incidentally during the study of other abdominal diseases. Up to 10% may present with rupture, which implies a high morbidity and mortality. Treatment of splenic aneurysms is still a subject of controversy and there is a great variety of therapeutic modalities. We present two cases of patients with splenic aneurysms: one who presented with rupture and the other one incidentally diagnosed. Both were treated with endovascular embolization achieving optimal results. Although the utility of this therapy has not been assessed for giant or ruptured aneurysms, it allowed us to solve these scenarios in a secure and effective way, with minimum morbidity and mortality.
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February 2021

[Giant colonic diverticulum. A strange entity].

Medicina (B Aires) 2020 ;80(6):705

Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Argentina.

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March 2021

[Ileal endometriosis. An uncommon cause of bowel obstruction in women in fertile age].

Medicina (B Aires) 2020 ;80(5):566-569

Servicio de Cirugía General Hospital Italiano de Buenos Aires, Argentina.

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It affects ~5-10% of women in their reproductive years. When it affects the intestine, it tends to be confused clinically with a wide variety of affections, which is why it has sometimes been called "the great simulator". A review of the literature shows that intestinal localization is rare and that obstruction secondary to this cause is even more unusual, with preoperative diagnosis being a challenge for surgeons. With the purpose of highlighting clinical and diagnostic imaging characteristics that help the preoperative suspicion of this entity, so rare in routine practice, we present two cases of women who underwent emergency surgery, without a previous diagnosis of endometriosis and with intestinal occlusion as the first manifestation of the disease. Treatment of intestinal occlusion by endometriosis consists of intestinal resection of the affected sector and primary anastomosis. Diagnosis of intestinal occlusion secondary to ileal endometriosis is based on a high index of suspicion and should be considered in women of childbearing age, without a history of disease and with a history of painful menstruation.
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November 2020
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