scholarly journals Gastric bypass in modern bariatric surgery

2020 ◽  
Vol 17 (2) ◽  
pp. 130-137
Author(s):  
Oral B. Ospanov ◽  
Galymzhan A. Yeleuov ◽  
Farida K. Bekmurzinova
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Surgical Treatment ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Promising Alternative ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Treatment Of Obesity ◽  
Surgical Treatment Of Obesity

The Roux-en-Y Gastric bypass surgery has long been considered as the gold standard method for the surgical treatment of obesity and its complications. But at present, this position is disputed by supporters of one-anastomotic gastric bypass and sleeve gastrectomy. The decrease in the share of gastric bypass in the structure of bariatric operations is explained by technical complexity, surgical and malabsorption complications. This review reflects the main role of gastric bypass as a bariatric surgery in the treatment of obesity and metabolic syndrome, and discloses various options for the technical implementation of gastric bypass surgery according to Roux-en-Y and alternative one-anastomotic gastric bypass surgery. The advantages and disadvantages of the stapler-use and stapleless method for performing bariatric operations are shown. In our opinion, one of the promising alternative concepts for the surgical treatment of obesity is stapleless one-anastomotic direction in gastric bypass surgery, but the known stapleless methods are imperfect and unsafe. Thus, based on the presented literature review, we can conclude that the imperfection of not only the stapler gastric bypass methods, but also the stapleless method. Therefore, a further research is needed for alternative surgical methods that would reduce the likelihood of surgical complications, reduce the cost of bariatric surgery and increase the accessibility of surgical treatment of obesity for the population.

Preoperative glucocorticoid use and risk of postoperative bleeding and infection after gastric bypass surgery for the treatment of obesity

2015 ◽  
Vol 11 (6) ◽  
pp. 1212-1217 ◽  
Author(s):  
Sigrid Bjerge Gribsholt ◽  
Elisabeth Svensson ◽  
Reimar Wernich Thomsen ◽  
Bjørn Richelsen ◽  
Henrik Toft Sørensen
Keyword(s):  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Postoperative Bleeding ◽  
Treatment Of Obesity

scholarly journals Roux-en-Y-Bariatric Surgery Reduces Markers of Metabolic Syndrome in Morbidly Obese Patients

2019 ◽  
Vol 30 (2) ◽  
pp. 391-400 ◽  
Author(s):  
G. Rega-Kaun ◽  
C. Kaun ◽  
G. Jaegersberger ◽  
M. Prager ◽  
M. Hackl ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Diabetic Patients ◽  
Obese Patients ◽  
C Peptide ◽  
Hepatic Insulin Clearance

Abstract Background Obesity is closely linked to increased markers of metabolic syndrome and development of diabetes. Roux-en-Y bariatric surgery reduces hyperinsulinemia and improves insulin sensitivity and hence benefits morbidly obese patients. Aim To determine changes in markers of metabolic syndrome, pancreatic function, and hepatic insulin sensitivity in patients before and 1 year after undergoing Roux-en-Y gastric bypass surgery. Methods We enrolled 43 consecutive patients in a single center. Markers for metabolic syndrome included proinsulin, insulin, C-peptide, liver enzymes, and serum levels of selected microRNAs hsa-miR-122, hsa-miR-130, hsa-miR-132, and hsa-miR-375. Results After surgery, all patients showed a significant 37% drop of body mass index (p < 0.001). Furthermore, proinsulin (59% reduction, p < 0.001), insulin (76% reduction, p < 0.001), and C-peptide (56% reduction, p < 0.001) were all reduced 1 year after surgery. Using the hepatic insulin clearance score, we determined a significant increase in hepatic insulin clearance after surgery (76% increase, p < 0.001). Especially diabetic patients showed a marked 2.1-fold increase after surgery. Hepatic enzymes ALT (35% reduction, p = 0.002) and γGT (48% reduction, p < 0.001) were significantly reduced in all patients with similar improvement in diabetic and non-diabetic patients. miRNAs hsa-miR-122, hsa-miR-130, and hsa-miR-132 were all significantly reduced whereas hsa-miR-375 was increased after gastric bypass surgery (p < 0.001 for all miRNAs). Conclusion Both liver and pancreatic stress parameters were reduced significantly 1 year after Roux-en-Y gastric bypass surgery suggesting an overall amelioration of the metabolic syndrome in all patients regardless of previous health status.

scholarly journals Association of Circulating Irisin Concentrations with Weight Loss after Roux-en-Y Gastric Bypass Surgery

2019 ◽  
Vol 16 (4) ◽  
pp. 660 ◽  
Author(s):  
Yeon Lee ◽  
Yoonseok Heo ◽  
Ji-Ho Choi ◽  
Sunghyouk Park ◽  
Kyoung Kim ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Excess Weight Loss ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Preoperative Serum ◽  
One Year

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 μg/mL, range 0.73–1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 μg/mL (range 0.92–1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R2 = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.

scholarly journals Genetic markers of abdominal obesity and weight loss after gastric bypass surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252525
Author(s):  
Martin Aasbrenn ◽  
Mathilde Svendstrup ◽  
Theresia M. Schnurr ◽  
Dorte Lindqvist Hansen ◽  
Dorte Worm ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Abdominal Obesity ◽  
Bypass Surgery ◽  
Risk Allele ◽  
Gastric Bypass Surgery ◽  
Genetic Determinants ◽  
Risk Alleles ◽  
Baseline Bmi

Background Weight loss after bariatric surgery varies widely between individuals, partly due to genetic differences. In addition, genetic determinants of abdominal obesity have been shown to attenuate weight loss after dietary intervention with special attention paid to the rs1358980-T risk allele in the VEGFA locus. Here we aimed to test if updated genetic risk scores (GRSs) for adiposity measures and the rs1358980-T risk allele are linked with weight loss following gastric bypass surgery. Methods Five hundred seventy six patients with morbid obesity underwent Roux-en-Y gastric bypass. A GRS for BMI and a GRS for waist-hip-ratio adjusted for BMI (proxy for abdominal obesity), respectively, were constructed. All patients were genotyped for the rs1358980-T risk allele. Associations between the genetic determinants and weight loss after bariatric surgery were evaluated. Results The GRS for BMI was not associated with weight loss (β = -2.0 kg/100 risk alleles, 95% CI -7.5 to 3.3, p = 0.45). Even though the GRS for abdominal obesity was associated with an attenuated weight loss response adjusted for age, sex and center (β = -14.6 kg/100 risk alleles, 95% CI -25.4 to -3.8, p = 0.008), it was not significantly associated with weight loss after adjustment for baseline BMI (β = -7.9 kg/100 risk alleles, 95% CI -17.5 to 1.6, p = 0.11). Similarly, the rs1358980-T risk allele was not significantly associated with weight loss (β = -0.8 kg/risk allele, 95% CI -2.2 to 0.6, p = 0.25). Discussion GRSs for adiposity derived from large meta-analyses and the rs1358980-T risk allele in the VEGFA locus did not predict weight loss after gastric bypass surgery. The association between a GRS for abdominal obesity and the response to bariatric surgery may be dependent on the association between the GRS and baseline BMI.

scholarly journals Longitudinal assessment of the quality of life of patients after gastric bypass

2020 ◽  
Author(s):  
DEISE SILVA DE MOURA ◽  
LUCIANA DAPIEVE PATIAS ◽  
NATHALY MARIN HERNANDEZ ◽  
RAQUEL PIPPI ANTONIAZZI ◽  
GLAUCO DA COSTA ALVAREZ ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Sf 36 ◽  
Wide Range ◽  
The Impact

Abstract Background Bariatric surgery is currently considered an effective way to lose weight after failure in the clinical treatment over a 2-year period. Severe obesity is associated with a wide range of serious health complications and reduced health-related quality of life and throughout its context has a significant impact on the health, longevity and quality of life of individuals. The objective of this study was to monitor the impact of weight reduction, induced by bariatric gastric bypass surgery, on the quality of life of pre and post-operative patients at 1, 2 and 6 months. Methods Longitudinal observational study conducted from December 2016 to October 2017 in southern Brazil. The convenience sample consisted of 104 obese individuals eligible to undergo bariatric gastric bypass surgery. The quality of life evaluation was performed using the SF-36 self-administered questionnaire (The Medical Outcomes Study Short Form Health Survey). Results Obese patients presented significant weight loss after surgery and in the evaluation of quality of life the mean scores of the 8 domains of the SF-36 obtained a significant improvement (p <0.001) between time 0 and 6, as well as the components of mental health (vitality, social aspects, emotional aspects and mental health) and physical health component (functional capacity, physical aspects, pain and general state of health). Conclusions Patients who underwent gastric bypass bariatric surgery had significant improvements in quality of life during the 6 postoperative months.

scholarly journals Principles of bariatric surgery (review of literature)

2019 ◽  
Vol 26 (2) ◽  
pp. 9-11
Author(s):  
D. I. Vasilevskiy ◽  
Yu. I. Sedletskiy ◽  
L. I. Davletbaeva
Keyword(s):  
Bariatric Surgery ◽  
Surgical Treatment ◽  
Historical Perspective ◽  
Review Of Literature ◽  
Negative Experience ◽  
Practical Medicine ◽  
Surgical Interventions ◽  
Associated Diseases ◽  
Treatment Of Obesity ◽  
Surgical Treatment Of Obesity

Surgical treatment of obesity and associated diseases, like any other field of practical medicine, is based on certain laws and conditions. All the principles of bariatric surgery were formulated in the process of accumulating a positive and negative experience of using various surgical interventions. The article presents an historical perspective on the evolution of views on the fundamental principles of the operative treatment of obesity and associated diseases.

scholarly journals Potential Effects of Bariatric Surgery on the Incidence of Heart Failure and Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus and Obesity and on Mortality in Patients With Preexisting Heart Failure: A Nationwide, Matched, Observational Cohort Study

2021 ◽  
Author(s):  
Gudrún Höskuldsdóttir ◽  
Naveed Sattar ◽  
Mervete Miftaraj ◽  
Ingmar Näslund ◽  
Johan Ottosson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery

Background Obesity and diabetes mellitus are strongly associated with heart failure (HF) and atrial fibrillation (AF). The benefits of bariatric surgery on cardiovascular outcomes are known in people with or without diabetes mellitus. Surgical treatment of obesity might also reduce the incidence of HF and AF in individuals with obesity and type 2 diabetes mellitus (T2DM). Methods and Results In this register‐based nationwide cohort study we compared individuals with T2DM and obesity who underwent Roux‐en‐Y gastric bypass surgery with matched individuals not treated with surgery. The main outcome measures were hospitalization for HF and/or AF and mortality in patients with preexisting HF. We identified 5321 individuals with T2DM and obesity who had undergone Roux‐en‐Y gastric bypass surgery between January 2007 and December 2013 and 5321 matched controls. The individuals included were 18 to 65 years old and had a body mass index >27.5 kg/m 2 . The follow‐up time for hospitalization was until the end of 2015 (mean 4.5 years) and the end of 2016 for death. Our results show a 73% lower risk for HF (hazard ratio [HR], 0.27; CI, 0.19–0.38), 41% for AF (HR, 0.59; CI, 0.44–0.78), and 77% for concomitant AF and HF (HR, 0.23; CI, 0.12–0.46) in the surgically treated group. In patients with preexisting HF we observed significantly lower mortality in the group who underwent surgery (HR, 0.23; 95% CI, 0.12–0.43). Conclusions Bariatric surgery may reduce risk for HF and AF in patients with T2DM and obesity, speculatively via positive cardiovascular and renal effects. Obesity treatment with surgery may also be a valuable alternative in selected patients with T2DM and HF.

scholarly journals GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass

2015 ◽  
Vol 2015 ◽  
Author(s):  
Marta Guimarães ◽  
Pedro Rodrigues ◽  
Sofia S Pereira ◽  
Mário Nora ◽  
Gil Gonçalves ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Differential Diagnosis ◽  
Chromogranin A ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Clinical Manifestations ◽  
Low Grade ◽  
List Type ◽  
Reactive Hypoglycemia

Summary Post-prandial hypoglycemia is frequently found after bariatric surgery. Although rare, pancreatic neuroendocrine tumors (pNET), which occasionally are mixed hormone secreting, can lead to atypical clinical manifestations, including reactive hypoglycemia. Two years after gastric bypass surgery for the treatment of severe obesity, a 54-year-old female with previous type 2 diabetes, developed post-prandial sweating, fainting and hypoglycemic episodes, which eventually led to the finding by ultrasound of a 1.8-cm solid mass in the pancreatic head. The 72-h fast test and the plasma chromogranin A levels were normal but octreotide scintigraphy showed a single focus of abnormal radiotracer uptake at the site of the nodule. There were no other clinical signs of hormone secreting pNET and gastrointestinal hormone measurements were not performed. The patient underwent surgical enucleation with complete remission of the hypoglycemic episodes. Histopathology revealed a well-differentiated neuroendocrine carcinoma with low-grade malignancy with positive chromogranin A and glucagon immunostaining. An extract of the resected tumor contained a high concentration of glucagon (26.707 pmol/g tissue), in addition to traces of GLP1 (471 pmol/g), insulin (139 pmol/g) and somatostatin (23 pmol/g). This is the first report of a GLP1 and glucagon co-secreting pNET presenting as hypoglycemia after gastric bypass surgery. Although pNET are rare, they should be considered in the differential diagnosis of the clinical approach to the post-bariatric surgery hypoglycemia patient. Learning points pNETs can be multihormonal-secreting, leading to atypical clinical manifestations. Reactive hypoglycemic episodes are frequent after gastric bypass. pNETs should be considered in the differential diagnosis of hypoglycemia after bariatric surgery.

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