Fast-Track in Bariatric and Metabolic Surgery: Feasibility and Cost Analysis Through a Matched-Cohort Study in a Single Centre.

Background: Due to the rise in severe obesity in Western countries and the increase in bariatric surgery, enhanced recovery (ER) pathways should be developed and promoted.

Methods: A monocentric prospective series of 103 bariatric surgery patients managed with the ER pathway (group ER) was compared with a retrospective and immediately previous series of 103 patients managed with standard care (group CS). The aim of the present study was to assess and compare the differences in terms of mean postoperative length of stay (LOS), costs for surgery and recovery, and the differences in terms of complications, readmission, and reoperation rate in the short term between the ER and CS groups.

Pure laparoscopic pancreatoduodenectomy with initial approach to the superior mesenteric artery.

Introduction: The "artery-first approach" (AFA) to the superior mesenteric artery allows an early assessment of resectability of pancreatic tumours and could improve the benefits of laparoscopy, reducing invasiveness, especially for unresectable tumours.

Aim: To describe our technique of pure laparoscopic pancreatoduodenectomy (PLPD) with the AFA, and to report the surgical outcomes of this procedure in a small series of 12 patients through a retrospective analysis of a prospectively collected database.

Material And Methods: Twelve selected patients underwent elective full laparoscopic pancreatoduodenectomy with the AFA.

Totally laparoscopic 95% gastrectomy for cancer: technical considerations.

Introduction: Total gastrectomy is the standard treatment for tumours arising in the proximal stomach and for diffuse cancer according to the Lauren classification. Laparoscopic approach is progressively accepted and provides encouraging results. In order to reduce complications associated to the esophago-jejunal anastomosis, the concept of the 95 % open gastrectomy was developed in Japan, in the early 1980s.

Minimally invasive management of postoperative esophagojejunal anastomotic leak.

Purpose: Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and affects the long-term survival rate.

Methods: Between 2003 and 2011, 38 patients underwent laparoscopic total gastrectomy and 2 developed an esophagojejunal fistula.

Results: The diagnosis was established by a computed tomography scan with contrast ingestion.

Barbed versus usual suture for closure of the gastrojejunal anastomosis in laparoscopic gastric bypass: a comparative trial.

Background: Laparoscopic Roux-en-Y gastric bypass is one of the main bariatric procedures that require safe and reproducible anastomosis. The objective of this study is to compare the risk of leaks and stenosis of a mechanical gastric pouch jejunal anastomosis between the usual interrupted sutures and a continuous barbed suture for gastrojejunotomy, in order to reduce procedure time and costs.

Methods: A comparative trial of 100 consecutive patients undergoing laparoscopic Roux-en-Y gastric bypass was performed between October 2010 and July 2011.