Endoscopic Management of Bariatric Surgery Complications According to a Standardized Algorithm.

Background And Aims: Endoscopy is effective in management of bariatric surgery (BS) adverse events (AEs) but a comprehensive evaluation of long-term results is lacking. Our aim is to assess the effectiveness of a standardized algorithm for the treatment of BS-AE.

Patients And Methods: We retrospectively analyzed 1020 consecutive patients treated in our center from 2012 to 2020, collecting data on demographics, type of BS, complications, and endoscopic treatment.

Endoscopic internal drainage for the management of leak, fistula, and collection after sleeve gastrectomy: our experience in 617 consecutive patients.

Background: Endoscopy plays a pivotal role in the management of adverse events (AE) following bariatric surgery. Leaks, fistulae, and post-operative collection after sleeve gastrectomy (SG) may occur in up to 10% of cases.

Objectives: To evaluate the efficacy and safety of endoscopic internal drainage (EID) for the management of leak, fistula, and collection following SG.

Bariatric surgery induces a new gastric mucosa phenotype with increased functional glucagon-like peptide-1 expressing cells.

Glucagon-Like Peptide-1 (GLP-1) undergoes rapid inactivation by dipeptidyl peptidase-4 (DPP4) suggesting that target receptors may be activated by locally produced GLP-1. Here we describe GLP-1 positive cells in the rat and human stomach and found these cells co-expressing ghrelin or somatostatin and able to secrete active GLP-1 in the rats. In lean rats, a gastric load of glucose induces a rapid and parallel rise in GLP-1 levels in both the gastric and the portal veins.

Comparison of Repeat Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Case of Weight Loss Failure After Sleeve Gastrectomy.

Background: Few series are available on the results of repeat sleeve gastrectomy (re-SG) and Roux-en-Y gastric bypass (RYGB) performed to manage the failure of primary sleeve gastrectomy (SG). The objective of this study was to compare the short- and medium-term outcomes of re-SG and RYGB after SG.

Material & Methods: Between January 2010 and December 2017, patients undergoing re-SG (n = 61) and RYGB (n = 83) for failure of primary SG were included in this study.

Diagnostic Performance of C-Reactive Protein in Detecting Post-Operative Infectious Complications After Laparoscopic Sleeve Gastrectomy.

Background: Gastric leak is the most common and dreaded post-operative infectious complication (PIC) after laparoscopic sleeve gastrectomy (LSG). Accurate identification of patients at risk postoperatively is of cardinal importance.

Objective: The aim of this study is to assess the diagnostic performance of C-reactive protein (CRP) in predicting PICs and the most optimal time to measure it.

Desire for Core Tastes Decreases After Sleeve Gastrectomy: a Single-Center Longitudinal Observational Study with 6-Month Follow-up.

Introduction: Laparoscopic sleeve gastrectomy (LSG) modifies gastrointestinal substances that control hunger and satiation via the brain-gut axis. A potential mechanism implicated in weight loss is the shift in food preferences. Our aim was to assess changes in taste preferences and their relationship to weight loss.

Laparoscopic Adjustable Gastric Banding: Predictive Factors for Weight Loss and Band Removal After More than 10 Years' Follow-Up in a Single University Unit.

Background: Weight loss and overall outcomes following laparoscopic adjustable gastric banding (LAGB) are more variable than with other bariatric procedures. Our aim was to investigate the predictive value of certain parameters in a cohort of 794 patients with 10 years' minimum follow-up after LAGB.

Methods: We retrospectively reviewed the records of 794 patients undergoing LAGB performed by the authors between April 1996 and December 2004.

Contribution of Computed Tomographic Imaging to the Management of Acute Abdominal Pain after Gastric Bypass: Correlation Between Radiological and Surgical Findings.

Background: We evaluated the diagnostic accuracy of first interpretations of computed tomographic (CT) images and blind interpretation using predefined CT signs in patients with previous Roux-en-Y gastric bypass (RYGBP) and acute abdominal pain.

Methods: We performed a retrospective chart review of patients with RYGBP who underwent surgical exploration from January 2009 to December 2014 for acute abdominal pain in our university institution, excluding patients without CT scan and comparing initial CT imaging interpretation with surgical findings. Two blinded radiologist specialists in bariatric imaging evaluated the CT images for seven previously reported CT signs.

Pneumatic dilation for functional helix stenosis after sleeve gastrectomy: long-term follow-up (with videos).

Background: A large number of patients who undergo laparoscopic sleeve gastrectomy present with surgical complications. Stenosis, in particular, occurs in .7%-4% of cases.

Sleeve Gastrectomy Combined with the Simplified Hill Repair in the Treatment of Morbid Obesity and Gastro-esophageal Reflux Disease: Preliminary Results in 14 Patients.

Background: Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR).

Methods: Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire. LSG+sLHR surgical technique: posterior cruroplasty,  standard LSG, fixation of the esophagogastric junction to the median arcuate ligament.

Classification, surgical management and outcomes of patients with gastrogastric fistula after Roux-En-Y gastric bypass.

Background: Gastrogastric fistula (GGF) is a known complication after Roux-en-Y gastric bypass that can lead to marginal ulceration (MU) and failure of weight loss.

Objectives: To describe our experience with GGF management and propose a classification of GGF based on its anatomic location.

Setting: University hospital, France.

Malabsorption and intestinal adaptation after one anastomosis gastric bypass compared with Roux-en-Y gastric bypass in rats.

The technically easier one-anastomosis (mini) gastric bypass (MGB) is associated with similar metabolic improvements and weight loss as the Roux-en-Y gastric bypass (RYGB). However, MGB is controversial and suspected to result in greater malabsorption than RYGB. In this study, we compared macronutrient absorption and intestinal adaptation after MGB or RYGB in rats.

Characteristics and outcomes of anti-infective de-escalation during health care-associated intra-abdominal infections.

Background: De-escalation is strongly recommended for antibiotic stewardship. No studies have addressed this issue in the context of health care-associated intra-abdominal infections (HCIAI). We analyzed the factors that could interfere with this process and their clinical consequences in intensive care unit (ICU) patients with HCIAI.

Differences in Alimentary Glucose Absorption and Intestinal Disposal of Blood Glucose After Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy.

Background & Aims: Bariatric procedures, such as Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), are the most effective approaches to resolve type 2 diabetes in obese individuals. Alimentary glucose absorption and intestinal disposal of blood glucose have not been directly compared between individuals or animals that underwent RYGB vs VSG. We evaluated in rats and humans how the gut epithelium adapts after surgery and the consequences on alimentary glucose absorption and intestinal disposal of blood glucose.

Laparoscopic Roux-en-Y gastric bypass for failed gastric banding: outcomes in 642 patients.

Background: Laparoscopic adjustable gastric banding (LAGB) is a well-tolerated procedure but has high long-term complication and failure rates. Laparoscopic conversion to Roux-en-Y gastric bypass (LRYGB) is one of the rescue strategies.

Objectives: To analyze short- and long-term results of reoperative LRYGB after failed LAGB.

Gastrojejunostomy stricture rate: comparison between antecolic and retrocolic laparoscopic Roux-en-Y gastric bypass.

Background: Roux-en-Y gastric bypass procedure is an effective treatment for morbid obesity. One of the most frequent complications after this operation is the appearance of a gastrojejunal anastomotic stricture. Mechanisms underlying the development of such complication are unclear.

Dynamic changes of microbial flora and therapeutic consequences in persistent peritonitis.

Introduction: Persistent peritonitis is a frequent complication of secondary peritonitis requiring additional reoperations and antibiotic therapy. This situation raises specific concerns due to microbiological changes in peritoneal samples, especially the emergence of multidrug-resistant (MDR) strains. Although this complication has been extensively studied, the rate and dynamics of MDR strains have rarely been analysed.

Diagnosis and management of the postoperative surgical and medical complications of bariatric surgery.

Perioperative complications following bariatric surgery (BS) have been poorly analysed and their management is not clearly assessed. The associated frequency of ICU admission is difficult to estimate. Among surgical complications, digestive perforations are the most frequent.

Remodeling of the residual gastric mucosa after roux-en-y gastric bypass or vertical sleeve gastrectomy in diet-induced obese rats.

Whereas the remodeling of intestinal mucosa after bariatric surgeries has been the matter of numerous studies to our knowledge, very few reported on the remodeling of the residual gastric mucosa. In this study, we analyzed remodeling of gastric mucosa after Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) in rats. Diet-induced obese rats were subjected to RYGB, VSG or sham surgical procedures.

Comparison of marginal ulcer rates between antecolic and retrocolic laparoscopic Roux-en-Y gastric bypass.

Introduction: Marginal ulcer can be a serious complication after laparoscopic gastric bypass surgery. The aim of this study was to compare the rates of marginal ulcer between the antecolic and the retrocolic technique, in a large cohort of patients.

Patients And Methods: Over a near 10-year period, 1,142 patients underwent laparoscopic gastric bypass surgery.