scholarly journals Bariatric surgery proves long-term benefit in patients with cirrhosis

2020 ◽  
Author(s):  
Manhal Izzy ◽  
Mounika Angirekula ◽  
Barham K Abu Dayyeh ◽  
Fateh Bazerbachi ◽  
Kymberly D Watt
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Descriptive Analysis ◽  
Total Body Weight ◽  
Hepatitis C Infection ◽  
Long Term Outcomes ◽  
Hepatic Decompensation ◽  
Compensated Cirrhosis

Abstract Background Obesity is commonly observed in patients with cirrhosis, especially with the increasing prevalence of non-alcoholic steatohepatitis (NASH). Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk; therefore, data are lacking regarding long-term outcomes. In this study, we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric surgery. Methods We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23, 2009 and November 9, 2011, and followed in a pilot study for evaluation of bariatric surgery outcomes. Only patients with more than 4 years of follow-up were included in the analysis. Data regarding their liver disease, metabolic status, and survival were collected. A descriptive analysis was performed. Results The cohort consisted of 10 patients, of whom 7 were females. The median post-surgical follow-up was 8.7 years (± 1.4 years). All patients had biopsy-proven NASH; two patients had concurrent, untreated hepatitis C infection. During the observation period, there was a mean weight loss of 24 kg (19.2% of total body weight pre surgery, P < 0.001) and only one patient regained weight to the baseline pre-surgical measurement. One patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later died. The remainder of the patients did not have any hepatic decompensation, cardiovascular event, or mortality. Except for one patient with Gilbert syndrome, bilirubin was normal in all patients at last follow-up. Conclusions Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-term follow-up.

scholarly journals Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

2022 ◽  
Vol 12 ◽  
Author(s):  
Esphie Grace Fodra Fojas ◽  
Saradalekshmi Koramannil Radha ◽  
Tomader Ali ◽  
Evan P. Nadler ◽  
Nader Lessan
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Glycemic Control ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Short Term ◽  
Melanocortin 4 Receptor ◽  
Significant Difference

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

scholarly journals Long-Term Weight Loss and Metabolic Syndrome Remission after Bariatric Surgery: The Effect of Sex, Age, Metabolic Parameters and Surgical Technique – A 4-Year Follow-Up Study

Obesity Facts ◽  
2019 ◽  
Vol 12 (6) ◽  
pp. 639-652 ◽  
Author(s):  
Vanessa Guerreiro ◽  
João Sérgio Neves ◽  
Daniela Salazar ◽  
Maria João Ferreira ◽  
Sofia Castro Oliveira ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Surgical Technique ◽  
Metabolic Parameters ◽  
Follow Up Study

Foregut Issues After Bariatric Surgery

2022 ◽  
pp. 263451612110674
Author(s):  
Fareed Cheema ◽  
Aurora D. Pryor
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Postoperative Complications ◽  
Weight Loss Surgery ◽  
Long Term Outcomes ◽  
Operative Complications ◽  
Complications After Bariatric Surgery ◽  
Broad Scale ◽  
Post Operative Complications

Weight loss surgery has overall been shown to be very safe and effective. However, long-term outcomes data has allowed codification of post-operative complications specific to the type of weight loss surgery performed. This review focuses specifically on foregut-related postoperative complications after weight loss surgery, most of which are not discussed on a broad scale in the literature yet whose prevalence continues to rise. Clinicians should maintain a broad differential when treating patients with complications after bariatric surgery in order to perform a thorough and precise workup to identify the diagnosis and guide management.

Comparative Effectiveness of Gastric Bypass and Vertical Sleeve Gastrectomy for Hypertension Remission and Relapse: The ENGAGE CVD Study

Hypertension ◽  
2021 ◽  
Author(s):  
Kristi Reynolds ◽  
Lee J. Barton ◽  
Anirban Basu ◽  
Heidi Fischer ◽  
David E. Arterburn ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Vertical Sleeve Gastrectomy ◽  
Variable Approach ◽  
Study Population ◽  
Instrumental Variable Approach

Weight loss is an effective strategy for the management of hypertension, and bariatric surgery is the most effective weight loss and maintenance strategy for obesity. The importance of bariatric surgery in the long-term management of hypertension and which operation is most effective is less clear. We compared the effectiveness of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) for remission and relapse of hypertension after surgery in the ENGAGE CVD cohort study (Effectiveness of Gastric Bypass Versus Gastric Sleeve for Cardiovascular Disease). Operations were done by 23 surgeons across 9 surgical practices. Hypertension remission and relapse were assessed in each year of follow-up beginning 30 days and up to 5 years postsurgery. We used a local instrumental variable approach to account for selection bias in the choice of VSG or RYGB. The study population included 4964 patients with hypertension at the time of surgery (n=3186 VSG and n=1778 RYGB). At 1 year, 27% of patients with RYGB and 28% of patients with VSG achieved remission. After 5 years, without accounting for relapse, 42% of RYGB and 43% of VSG patients had experienced hypertension remission. After accounting for relapse, only 17% of RYGB and 18% of VSG patients remained in remission 5 years after surgery. There were no statistically significant differences between VSG and RYGB for hypertension remission, relapse, or mean systolic and diastolic blood pressure at any time during follow-up.

Long-term outcomes of laser-assisted uvulopalatoplasty in 168 patients with snoring

2006 ◽  
Vol 120 (11) ◽  
pp. 932-938 ◽  
Author(s):  
T Iyngkaran ◽  
J Kanagalingam ◽  
R Rajeswaran ◽  
C Georgalas ◽  
B Kotecha
Keyword(s):  
Weight Loss ◽  
Telephone Survey ◽  
Subjective Improvement ◽  
Long Term Outcomes ◽  
Sleep Studies ◽  
The Mean ◽  
Term Benefit ◽  
Sleep Nasendoscopy

Laser-assisted uvulopalatoplasty (LAUP) is an established treatment for snoring. Our institution has been using a modification of the Kamami technique since 1995. Between January 1995 and December 2001, 469 patients underwent LAUP for snoring. A telephone survey of these patients and their partners was conducted retrospectively. One hundred and sixty-eight patients and their partners were interviewed and the findings analysed.Of the 168 patients, 122 had LAUP alone, 42 had LAUP and tonsillectomy and four had LAUP and septoplasty. The median follow-up time was 59 months (range 19 to 98 months).Seventy-four per cent reported improvement at six weeks, 69 per cent reported improvement at nine months and 55 per cent reported improvement at the time of interview. To assess the degree of improvement, patients and their partners were asked to grade any improvement in percentage terms. The mean subjective improvement scores were 57 per cent at six weeks (95 per cent confidence interval (CI) 50–64 per cent), 45 per cent at nine months (95 per cent CI 38–59 per cent) and 30 per cent at the time of interview (95 per cent CI 23–35 per cent). Patients who reported weight gain since surgery did not have a poorer outcome than those who reported no weight change or weight loss. Neither did weight loss predict a better outcome. The procedure was generally well tolerated, with only 30 patients (18 per cent) reporting complications (mainly minor).The benefits of LAUP wane with time and the results are best in the first 12 months following surgery. Our study suggests that 55 per cent of patients selected after sleep studies and sleep nasendoscopy will enjoy long-term benefit.

scholarly journals Bariatric surgery: a potential cure for asthma?

2019 ◽  
Vol 28 (152) ◽  
pp. 190003 ◽  
Author(s):  
Toufic A. Chaaban
Keyword(s):  
Bariatric Surgery ◽  
Long Term Outcomes ◽  
Asthmatic Patients ◽  
Asthma Incidence ◽  
Related Hospitalisation ◽  
Asthma Outcomes ◽  
Weight Loss Interventions

Asthma incidence and severity are increased in obese populations. Systematic reviews have shown benefit from weight-loss interventions on asthma outcomes, but the role of bariatric surgery is still unclear. In this review, cohorts of obese asthmatic patients undergoing bariatric surgery were examined regarding different asthma outcomes. The available data on patients who were followed up showed improvements in asthma control, exacerbation risk, asthma-related hospitalisation, medication use and airway hyperresponsiveness, with some patients not requiring further treatment for asthma. Follow-up duration was variable, being mostly of 1 year, with some studies reporting long-term outcomes after 5 years. The studies reviewed had many limitations, including small numbers of patients, lack of control arm in some studies and lack of standardisation of asthma diagnosis, classification and outcome measures, in addition to possible reporting bias. Data on small numbers of patients also show the possibility of benefit exclusively in nonallergic asthma. Larger, more stringent clinical trials are needed before recommending bariatric surgery for treatment of asthma.

Impact of Routine and Long-Term Follow-Up on Weight Loss after Bariatric Surgery

2020 ◽  
Vol 30 (11) ◽  
pp. 4293-4299
Author(s):  
J. Lujan ◽  
C. Tuero ◽  
M. F. Landecho ◽  
R. Moncada ◽  
J. A. Cienfuegos ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Long Term Follow Up
Sign in / Sign up

Export Citation Format

Share Document