Multimedia Library
Single and dual anastomosis duodenal switch for obesity treatment: a single-center experience
Biliopancreatic diversion with duodenal switch (BPD/DS) is the most effective bariatric surgery in super-obese patients, although technically complex and time consuming. As a primary surgery, single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is similar to BPD/DS in terms of short-term outcomes, but long-term and comparative data are lacking.Clinical periodontal conditions in individuals after bariatric surgery: a systematic review and meta-analysis
The aim of the present study was to perform a systematic review and meta-analysis to assess the influence of bariatric surgery on the clinical periodontal conditions in patients with obesity. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered at the International Prospective Registry of Systematic Reviews (CRD42018099313). A search was conducted by 2 investigators in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases for relevant articles published up to May 2018.Sleeve gastrectomy in obese Wistar rats improves diastolic function and promotes cardiac recovery independent of weight loss
Heart failure with preserved ejection fraction is the most common cause of heart failure and is characterized by impaired diastolic relaxation. Bariatric surgery significantly improves diastolic relaxation, but a mechanism beyond weight loss remains unknown.Laparoscopic loop duodenaljejunal bypass with sleeve gastrectomy in type 2 diabetic patients
Diabetes is an epidemic disease and is estimated to affect >300 million people worldwide in 2025 [1]. Type 2 diabetes (T2D) management is a combination of diet, lifestyle modifications, and drug therapy. Recently, many studies have shown remission of T2D in obese population [2–6]. Buchwald et al. [2] in his systemic review and meta-analysis showed that diabetes remission rates were 99% (95% confidence interval, 97%–100%) after biliopancreatic diversion, 84% (95% confidence interval, 77%–90%) after Roux-en-Y gastric bypass (RYGB), and 48% (95% confidence interval, 29%–67%) after gastric banding.Recent trends in intensive treatments of obesity: Is academic research matching public interest?
Overweight and obesity continues to be a serious public health concern. The World Health Organization estimated that the worldwide prevalence of obesity nearly tripled between 1975 and 2016, with 1.9 bilion adults being overweight in 2016 and, of these, 650 million were obese [1]. In addition to the pandemic escalation of obesity in developed nations, obesity is now on the rise in developing countries, such as China, India, and the rest of Asia. The World Health Organization estimates that >1.7 billion people worldwide are overweight or obese [2].Intragastric balloon as a bridge procedure in patients with high body mass index
Liver steatosis is a common complication of morbid obesity. As such, it can increase chances of operative complications. We present to you a case of liver steatosis in a morbidly obese patient in which we faced difficulty in the first attempt at sleeve gastrectomy and instead inserted a gastric balloon endoscopically as a bridge procedure for a later laparoscopic sleeve gastrectomy.PNPLA3 p.I148M variant is associated with greater reduction of liver fat content after bariatric surgery
Obesity is the major trigger of nonalcoholic fatty liver disease (NAFLD). NAFLD is further favored by the patatin-like phospholipase domain-containing 3 (PNPLA3) p.I148M, transmembrane 6 superfamily member 2 (TM6SF2) p.E167K, and membrane-bound O-acyltransferase domain containing 7 (MBOAT7) rs641738 variants.Sleeve gastrectomy leads to weight loss in the Magel2 knockout mouse
Prader-Willi syndrome (PWS) is a genetic disorder characterized by hyperphagia, obesity, cardiopulmonary diseases, and increased mortality. Although successful weight loss improves health in PWS, few treatments cause sustained weight loss in obese patients let alone obese individuals with PWS.Trans-oral Endoscopic Restrictive Implant System: endoscopic treatment of obesity?
Endoscopic treatment of obesity might be an alternative to surgical treatment or, preoperatively, serve as an auxiliary therapy to surgery in patients at increased surgical risk.Hepatic abscess as a complication of duodenal-jejunal bypass sleeve system and review of the literature
The obesity epidemic is steadily increasing worldwide, and high body mass index (BMI) is a major risk factor for cardiovascular diseases, diabetes, hypertension, musculoskeletal disorders, and also some cancers [1]. Diets are generally unsuccessful [2]. Bariatric surgery is today the main treatment for severe obesity [3]. There is a strong interest in finding less invasive methods [4] and whether that preoperative weight loss improves surgery outcomes [2] and reduces perioperative complications [5].Effectiveness of intragastric balloon for obesity: A systematic review and meta-analysis based on randomized control trials
Obesity has become a worldwide epidemic, and many methods are currently used to reduce obesity. This systematic review shows the effectiveness of the intragastric balloon (IGB) method compared to the sham/diet (s/d) method.Bariatric surgery acutely changes the expression of inflammatory and lipogenic genes in obese adipose tissue
Adipose tissue of obese subjects is known to exhibit increased inflammatory activity linked to altered expression of factors involved in glucose and lipid metabolism. The surgical procedure constitutes an injury per se, evoking a systemic inflammatory response.Gastric cancer: A de novo diagnosis after laparoscopic sleeve gastrectomy
Epidemiologic studies have suggested that obesity is associated with an increased risk of several cancers [1] such as colon and esophageal adenocarcinomas [2]. A positive association between body mass index (BMI) and gastric malignancies has only been described for adenocarcinomas of the gastric cardia, while the association between BMI and gastric noncardia adenocarcinoma is unclear [3]. A recent systematic review [4] analyzed all reported cases of esophageal or gastric cancers after several bariatric procedures, including vertical banded gastroplasty, gastric band, or Roux-en-Y gastric bypass; but only a case of a lower esophageal adenocarcinoma has been described in a patient who underwent a previous (4 months) sleeve gastrectomy (SG) [5].Increased levels of chemerin and its receptor, chemokine-like receptor-1, in obesity are related to inflammation: tumor necrosis factor-α stimulates mRNA levels of chemerin in visceral adipocytes from obese patients
Chemerin is a novel adipokine that regulates adipocyte development and metabolic function and glucose metabolism. Our aim was to determine the effect of chemerin and its receptor, chemokine-like receptor-1, in obesity-associated low-grade chronic inflammation, exploring its circulating and gene expression levels in obesity and the effect of weight loss and to analyze the effect of the stimulation with tumor necrosis factor-α in human visceral adipocytes at a University hospital.Diagnosis and treatment of Zollinger Ellison syndrome in a morbidly obese patient after Roux-en-Y gastric bypass
Zollinger Ellison syndrome (ZES) is rare entity characterized by recurrent peptic ulcers due to high acid production from gastric parietal cells as a result of elevated secretion of the hormone gastrin [1–5]. The abnormally high levels of gastrin are caused by a gastrin-secreting neuroendicrine tumor (gastrinoma) that frequently develops from the pancreas or from the first or second portion of the duodenum, in the denominated “gastrinoma triangle” [2–5]. Approximately 75% of ZES cases are sporadic, with the remaining 25% associated with multiple endocrine neoplasm type 1 [1].Laparoscopic repair of internal hernia during pregnancy after Roux-en-Y gastric bypass
Laparoscopic Roux-en-Y gastric bypass as a treatment of severe obesity has increased dramatically in the past decade, and most of the patients have been women [1,2]. The health risks experienced by obese women during pregnancy can be reduced by the weight loss induced by bariatric surgery [3–5], but these patients are at risk of bariatric surgical complications during their pregnancies. Women who have undergone Roux-en-Y gastric bypass for morbid obesity are at risk of internal hernias, intussusception, and small bowel obstruction during pregnancy, which can lead to maternal and/or fetal death [6].Laparoscopic placement of an adjustable gastric band in a super-super obese patient with situs inversus
Situs inversus, the rare genetic condition characterized by right–left transposition of the viscera, affects 1/5000 to 1/10,000 individuals [1]. Despite the low prevalence of this condition and the difficult anatomic considerations, several reports have been published of successful laparoscopic bariatric operations in patients with situs inversus, including sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding [2–6]. These reports have highlighted the difficulty in performing laparoscopic operations on patients with mirror image anatomy.First human experience with endoscopically delivered and retrieved duodenal-jejunal bypass sleeve
We report the first human experience with an endoscopic duodenal-jejunal bypass sleeve (DJBS) in a community hospital.
