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Surg Today 2021 Jun 9. Epub 2021 Jun 9.

Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China.

Purpose: To evaluate the long-term efficacy of large gastric pouch surgery and revisional surgery in patients with a body mass index (BMI) < 35 kg/m and type 2 diabetes mellitus (T2DM).

Methods: We conducted a retrospective review of patients who underwent laparoscopic Roux-en-Y gastrojejunostomy with a large gastric pouch in our hospital. The clinical pre- and post-surgery data, including BMI, waist circumference, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipid metabolism-related indicators, homoeostatic model assessment of insulin resistance (HOMA-IR), and major complications, were recorded and analyzed. Read More

Obes Surg 2021 Jun 9. Epub 2021 Jun 9.

Department of Surgery, State University of Londrina, Londrina, Brazil.

Introduction: Obesity may lead to hyperandrogenia and affect female sexual function. The study aims to evaluate female sexual function and androgenic profile in obese women after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods: Forty obese women with a mean age of 34 years were prospectively studied. Read More

Nutr Hosp 2021 Jun 9. Epub 2021 Jun 9.

Instituto de Laparoscopia Avanzada del Sureste (INLAPSUR).

Introduction: type-2 diabetes mellitus (DM2) is a major health problem, as it leads to increased morbidity and mortality. Metabolic surgery has shown good results in glycemic control; however, its use has not become popular.

Objectives: to evaluate DM2 remission, as well as changes in body mass index (BMI), in overweight diabetic patients after undergoing metabolic surgery. Read More

J Gastrointest Surg 2021 Jun 7. Epub 2021 Jun 7.

Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, 4002, Basel, Switzerland.

Purpose: A subset of patients undergoing Roux-en-Y gastric bypass (RYGB) presents with either insufficient weight loss or weight regain. Data on the revisional restrictive options including laparoscopic adjustable gastric band (LAGB) is scarce. This study analyzes the mid-term efficacy and safety of LAGB as a revisional procedure after RYGB. Read More

Surg Laparosc Endosc Percutan Tech 2021 Jun 7. Epub 2021 Jun 7.

Department of Surgery, Bariatric and Metabolic Surgery Unit, Santa Maria Nuova Hospital, Florence, Italy.

Background: The development of an intraluminal blood clot (hemobezoar), represents a rare cause (0.05% to 1.9%) of small bowel obstruction (SBO) after laparoscopic Roux-en-Y gastric bypass (LRYGB). Read More

Obes Surg 2021 Jun 3. Epub 2021 Jun 3.

Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar (East), New Delhi, 110029, India.

Medicina (Kaunas) 2021 May 17;57(5). Epub 2021 May 17.

Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.

Bariatric surgery remains the gold standard treatment for morbidly obese patients. Roux-en-y gastric bypass and laparoscopic sleeve gastrectomy are the most frequently performed surgeries worldwide. Obesity has also been related to gastroesophageal reflux disease (GERD). Read More

Children (Basel) 2021 May 9;8(5). Epub 2021 May 9.

Clinic for Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany.

Despite worldwide public attention and intense medical efforts, the prevalence of severe morbid obesity in children and adolescents is still rising. Similar to adults, excess adipose tissue triggers multiple immunological and metabolic pathways leading to serious co-morbidities such as impaired glucose tolerance or even type 2 diabetes (T2D), dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and hyperuricemia. The management of severe childhood obesity requires a life-long multidisciplinary approach with a combination of lifestyle changes, nutrition, and medications. Read More

Eat Weight Disord 2021 Jun 1. Epub 2021 Jun 1.

Department of Bariatric Surgery/Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.

Introduction: Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency.

Case Report: We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). Read More

Obes Surg 2021 Jun 1. Epub 2021 Jun 1.

The Second Gastric & Intestinal Department, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian City, 116033, Liaoning Province, China.

Purpose: Obesity and diabetes mellitus are now leading causes of chronic kidney disease. Our study investigated the effects of bariatric surgery on estimated glomerular filtration (eGFR) and urinary microalbumin/creatinine ratio (ACR) in morbidly obese patients.

Materials And Methods: The clinical materials for patients who underwent bariatric surgery were retrospectively analyzed with a 6-month follow-up period between January 1, 2018, and June 1, 2020. Read More

Obes Surg 2021 May 27. Epub 2021 May 27.

İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center, Fulya Mah. Yeşilçimen Sok. 12/407, 34394, Şişli, İstanbul, Turkey.

Nutr Hosp 2021 May 26. Epub 2021 May 26.

Endocrine and Bariatric Surgery Unit. Hospital Clínico Universitario.

Introduction: after laparoscopic Roux-en-Y gastric bypass (LRYGBP) many patients complain of epigastric pain or food intolerance, leading to the performance of upper gastrointestinal (UGI) endoscopy.

Objective: this study aims to assess which symptomatology as reported by LRYGBP patients during follow-up suggested correlation with pathological findings of endoscopy, and which factors might play a role, taking the timing of symptom presentation into account.

Materials And Methods: a retrospective cohort study was performed identifying LRYGBP patients presenting with food intolerance and/or epigastric pain who had undergone endoscopy. Read More

Obes Surg 2021 May 25. Epub 2021 May 25.

Department of Surgery, Barmherzige Schwestern Krankenhaus Wien, Stumpergasse 13, 1060, Vienna, Austria.

Gallstone disease after bariatric surgery is a common condition due to the obesity and rapid weight loss. Because of increasing obesity amongst the population, and the gastric bypass having been established as the standard treatment for morbid obesity, the occurrence of bile duct stones after this kind of surgery remains a therapeutic dilemma. We present a case of obstructed choledocholithiasis with shrinking of the gallbladder and consequent cholangitis in a 69-year-old Caucasian male patient after a laparoscopic Roux-and-Y gastric bypass (LRYGB), who underwent a successful laparoscopic single-stage bile stone removal of the choledochal duct using intraoperative ultrasound and choledochoscopy. Read More

Obes Surg 2021 May 24. Epub 2021 May 24.

Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Langenbecks Arch Surg 2021 May 23. Epub 2021 May 23.

BAROS - Cirurgia Bariátrica e Metabólica, Av. Prof. Magalhães Neto, 1541, sala 4012/13, Salvador, BA, 41810-011, Brazil.

Introduction: Technical variations of the laparoscopic Roux-en-Y gastric bypass may influence the incidence of complications such as fistulas, marginal ulcers, stenosis, and internal hernias.

Methods: We described the technical aspects of a retrocolic, retrogastric, laparoscopic gastric bypass procedure with manual gastrojejunostomy and the closure technique for the three mesenteric defects generated by the Roux-en-Y limb reconstruction.

Results: We summarized the data from 587 patients concerning complications directly related to the surgical technique. Read More

BMC Surg 2021 May 22;21(1):254. Epub 2021 May 22.

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Phytobezoar formation is a complication of bariatric surgery and mostly occurs after laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Here, we present an extremely rare case of late phytobezoar formation following laparoscopic sleeve gastrectomy (LSG).

Case Presentation: A 52-year-old woman with a body mass index (BMI) of 40. Read More

Langenbecks Arch Surg 2021 May 22. Epub 2021 May 22.

Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Claraspital and University Hospital Basel, CH-4002, Basel, Switzerland.

Purpose: Internal hernias (IH) are frequent complications after laparoscopic Roux-en-Y gastric bypass (LRYGB). Closure of the jejunal mesenteric and the Petersen defect reduces IH incidence in prospective and retrospective trials. This study investigates whether closing the jejunal mesenteric space alone by non-absorbable suture and splitting the omentum can be beneficial to prevent IH after LRYGB. Read More

Obes Surg 2021 May 21. Epub 2021 May 21.

Department of Gastro-Intestinal Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.

J Am Coll Surg 2021 May 17. Epub 2021 May 17.

University of Texas Health Science Center, School of Public Health; Center for Pediatric Population Health, UTHealth School of Public Health; Children's Health System of Texas. Electronic address:

Background: Immunosuppressant use increases risk of Clostridium difficile infection. To date, no studies have analyzed the relationship between immunosuppressant use and C difficile infections after metabolic and bariatric surgery (MBS).

Methods: A retrospective analysis of the 2015-2018 MBSAQIP data was conducted. Read More

Int J Comput Assist Radiol Surg 2021 May 19. Epub 2021 May 19.

ICube, University of Strasbourg, CNRS, IHU Strasbourg, France.

Purpose: Automatic segmentation and classification of surgical activity is crucial for providing advanced support in computer-assisted interventions and autonomous functionalities in robot-assisted surgeries. Prior works have focused on recognizing either coarse activities, such as phases, or fine-grained activities, such as gestures. This work aims at jointly recognizing two complementary levels of granularity directly from videos, namely phases and steps. Read More

Trials 2021 May 19;22(1):352. Epub 2021 May 19.

Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, 4002, Basel, Switzerland.

Background: Obesity and type 2 diabetes mellitus are reaching epidemic proportions. In morbidly obese patients, bariatric operations lead to sustained weight loss and relief of comorbidities in the majority of patients. Laparoscopic Roux-Y-gastric bypass (RYGB) is one of the most frequently performed operations, but it is still unknown why some patients respond better than others. Read More

Br J Surg 2021 May 3. Epub 2021 May 3.

Department of Gastrointestinal Surgery, Sichuan Cancer Hospital & Research Institute, School of Medicine, University of Electronic Science and Technology of China (UESTC), Chengdu, China.

Acta Diabetol 2021 May 18. Epub 2021 May 18.

Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital, University of Rome Tor Vergata, Rome, Italy.

Bariatric operations have been documented in clinical trials to promote remission or dramatic improvement of Type II Diabetes Mellitus and related comorbidities. Herein we review randomized trials and meta-analyses published during the last 20 years on the results of bariatric/metabolic surgery in obese patients with type 2 diabetes with the aim of highlighting the scientific evidence available. Several studies and RCTs in the last 20 years have showed outstanding results of bariatric/metabolic surgery on Type II diabetes and comorbidities in patients with either BMI > 35 kg/m or BMI < 35 kg/m. Read More

Obes Surg 2021 May 17. Epub 2021 May 17.

Department of Surgery, Spaarne Gasthuis, Spaarnepoort 1, Hoofddorp, 2134 TM, the Netherlands.

Percentage total weight loss (%TWL) might be better than percentage excess weight loss to express weight loss in bariatric surgery. In this systematic review, performed according to the PRISMA statement, results of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) are assessed in %TWL. A total of 13,426 studies were screened and 49 included, reporting data of 24,760 patients. Read More

Acta Chir Belg 2021 May 23:1-3. Epub 2021 May 23.

Gastrointestinal and Bariatric Surgery, Universitair Ziekenhuis Gent, Gent, Belgium.

Gastric remnant necrosis is a very rare, but potential life-threatening complication after laparoscopic Roux-en-Y gastric bypass (LRYGB). We report a case of gastric remnant necrosis that was complicated by peritonitis and resulted in septic shock in a 49-year-old woman who had undergone a LRYGB three months prior to admission. An emergent laparoscopy with subtotal gastrectomy was performed. Read More

Surg Endosc 2021 May 14. Epub 2021 May 14.

Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr. EH 122, Indianapolis, IN, 46202, USA.

Background: Chylous ascites is often reported in cases with lymphatic obstruction or after lymphatic injuries such as intraabdominal malignancies or lymphadenectomies. However, chylous ascites is also frequently encountered in operations for internal hernias. We sought to characterize the frequency and conditions when chylous ascites is encountered in general surgery patients. Read More

Obes Surg 2021 May 12. Epub 2021 May 12.

Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 80756, Taiwan.

Purpose: Laparoscopic gastric clipping (LGC) is a relatively novel restrictive bariatric surgery wherein a horizontal metallic clip is applied to the gastric fundus. Its intraoperative complications or the difficulties associated with the applied gastric clip (GC) during revisional procedures have seldom been mentioned. Herein, the experience of revisional procedures after initial gastric clipping is reported. Read More

Surg Endosc 2021 May 12. Epub 2021 May 12.

Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.

Background: Evidence-based guidelines on the appropriate amount of opioid medications to prescribe following bariatric surgery are lacking. We sought to determine our current opioid-prescribing practices, patient utilization, and satisfaction with pain control following elective bariatric surgery.

Methods: A retrospective chart review and phone survey were conducted on patients who underwent laparoscopic or robotic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from April 2018 to March 2019 at a single academic medical center. Read More

Surg Laparosc Endosc Percutan Tech 2021 May 11. Epub 2021 May 11.

Imperial College Weight Loss Centre, Imperial College Healthcare Trust, St Mary's Hospital, London, UK.

Background: The purpose of this study was to compare whether different linear stapler lengths used to form the gastrojejunostomy during laparoscopic Roux-En-Y gastric bypass affects mid-term weight loss outcomes.

Materials And Methods: A retrospective single center analysis was performed. Surgical technique was identical other than either a 35 or 45 mm linear stapler being used to form the gastrojejunostomy. Read More

Surg Obes Relat Dis 2021 Apr 9. Epub 2021 Apr 9.

Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Even though observational studies have suggested that poor preoperative diabetes control increases risk after major abdominal surgery, it is unclear whether this effect is seen in metabolic surgery patients.

Objectives: To determine whether poor preoperative diabetes control is associated with worse outcomes in patients with obesity and diabetes undergoing metabolic surgery.

Setting: Metabolic and Bariatric Surgery Quality Improvement Project (MBSAQIP) database. Read More