Routine Drain Placement in Roux-en-Y Gastric Bypass: An Expanded Retrospective Comparative Study of 755 Patients and Review of the Literature

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Abstract  Routine drain use after laparoscopic Roux-en-y gastric bypass (LRYGB) is still practiced by many bariatric surgeons. After
a patient in our program experienced intestinal obstruction secondary to a drain, we reevaluated our practice and hypothesized
drains would be of no benefit and potentially harmful after LRYGB. Retrospective record review of all patients undergoing
LRYGB from August 2005 to August 2009 was performed. As we changed our practice in December 2006, we have two comparable groups:
one with a drain placed at surgery and one without. All operations were otherwise performed in an identical fashion by three
fellowship-trained university surgeons. We compared outcomes between the two groups, particularly regarding gastrojejunal
(GJ) leaks. Jejunojejunal …

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Surgical Treatments for Obesity

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The twin epidemics of obesity and diabetes threaten the health and well-being of millions of Americans. As these conditions rise in tandem, bariatric surgery has become an increasingly popular treatment option. In the United States alone, over 220,000 bariatric surgery procedures were performed in 2009. At present, bariatric surgery is the only therapy that produces mean long-term weight losses of 15% or more of initial weight. (Source: The Psychiatric Clinics of North America)

Type 2 Diabetes Mellitus: A Possible Surgically Reversible Intestinal Dysfunction

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We present a literature review of the possible mechanisms of early normalization of glycemic homeostasis
after bariatric surgery, including intestinal gluconeogenesis, increased antidiabetogenic signals from L cells located in
the distal small intestine, and impaired secretion of diabetogenic signals in the upper part of the small intestine. Adding
to these potential mechanisms, unknown factors that regulate insulin sensitivity may be involved and altered by bariatric
surgery. This review discusses the various hypotheses about the mechanisms of glycemic control after bariatric surgery involving
intestinal bypass. Further research is essential to better understand these mechanisms and to identify potential new mechanisms
that might help in developing less invasive and safer alternativ…

Revision of Laparoscopic Adjustable Gastric Banding: Success or Failure?

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Conclusions  We report on a large cohort of LAGB revisions with 38 months of follow-up. Revision of failed LAGB by either refixation or
replacement of the band is successful and further increases weight loss.

Content Type Journal ArticleCategory Clinical ResearchPages 1-6DOI 10.1007/s11695-011-0556-1Authors
G. H. E. J. Vijgen, Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the NetherlandsR. Schouten, Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the NetherlandsL. Pelzers, Department of General Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the NetherlandsJ. W. Greve, Department of General Surgery, Atrium Medical Cen…

How obesity and bariatric surgery can affect asthma control

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To the Editor: We read with much interest the recently published article “Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation� by Dixon et al. At this juncture, we wish to share a few scientific facts on the published article. (Source: Journal of Allergy and Clinical Immunology)

ASMBS and ASGE issue white paper on endoscopic bariatric therapies (EBTs)

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(American Society for Gastrointestinal Endoscopy) The American Society for Gastrointestinal Endoscopy (ASGE) and the American Society for Metabolic & Bariatric Surgery (ASMBS) have issued a new white paper on the potential role of endoscopic bariatric therapies (EBTs) in treating obesity and obesity-related diseases like Type 2 diabetes. The white paper entitled, “A Pathway to Endoscopic Bariatric Therapies,” appears online in both GIE: Gastrointestinal Endoscopy and Surgery for Obesity and Related Diseases (SOARD). (Source: EurekAlert! – Medicine and Health)

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Arteriolar Function in Visceral Adipose Tissue Is Impaired in Human Obesity.

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CONCLUSIONS: Our findings provide clinical evidence that the visceral microenvironment may be intrinsically toxic to arterial health providing a potential mechanism by which visceral adiposity burden is linked to atherosclerotic vascular disease. Our findings also support the evolving concept that both adipose tissue quality and quantity may play significant roles in shaping cardiovascular phenotypes in human obesity.
PMID: 22095978 [PubMed – as supplied by publisher] (Source: Arteriosclerosis, Thrombosis and Vascular Biology)

Determinants of Increased Cardiovascular Disease in Obesity and Metabolic Syndrome.

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Authors: Vazzana N, Santilli F, Sestili S, Cuccurullo C, Davì G
Abstract
Obesity is associated with an increased mortality and morbidity for cardiovascular disease (CVD) and adipose tissue is recognised as an important player in obesity-mediated CVD. The diagnosis of the metabolic syndrome (MS) appears to identify substantial additional cardiovascular risk above and beyond the individual risk factors, even though the pathophysiology underlying this evidence is still unravelled. The inflammatory response related to fat accumulation may influence cardiovascular risk through its involvement not only in body weight homeostasis, but also in coagulation, fibrinolysis, endothelial dysfunction, insulin resistance (IR) and atherosclerosis. Moreover, there is evidence that oxidative stress …

Reversal of gastric plication after laparoscopic adjustable gastric banded plication.

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Authors: Goel R, Chang PC, Huang CK
PMID: 22178564 [PubMed – as supplied by publisher] (Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery)

Comment on: An online bariatric surgery information session is as effective as an in-person information session.

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Authors: Metcalf BN
PMID: 22197463 [PubMed – as supplied by publisher] (Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery)