Foregut (foregut exclusions) and hindgut (rapid transit of nutrients to the distal intestine) theories are the most commonly used explanations for the metabolic improvements observed after metabolic surgeries. However, several procedures that do not comprise duodenal exclusions, such as sleeve with jejunojejunal bypass, ileal interposition, and transit bipartition and sleeve gastrectomy were found to have similar diabetes remission rates when compared with duodenal exclusion procedures, such as gastric bypass, biliopancreatic diversion with duodenal switch, and diverted sleeve with ileal interposition. Moreover, the complete exclusion of the proximal intestine could result in the malabsorption of several important micronutrients. This article reviews commonly performed procedures, with and without foregut exclusion, to better comprehend whether there is a critical need to include foregut exclusion in metabolic surgery.
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http://dx.doi.org/10.3389/fendo.2022.1014901 | DOI Listing |
Am Surg
October 2024
Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Median arcuate ligament syndrome, or celiac artery compression syndrome (eponym: Dunbar syndrome), has historically been attributed to pathophysiologic vascular compression causing downstream ischemic symptoms of the organs supplied by the celiac trunk. However, the more we learn about the histology, clinical presentation, and treatment outcomes, health care providers are increasingly correlating the symptoms of MALS with the long-term, repetitive compression of the celiac ganglion rather than the celiac trunk. This article provides a comprehensive review of current MALS literature, emphasizing the multidisciplinary approach these patients require in all phases of their care.
View Article and Find Full Text PDFJ Clin Med
September 2024
Center for Interventional Endoscopy, AdventHealth, Orlando, FL 32803, USA.
Glucagon-like peptide receptor agonists (GLP-1 RAs) are associated with delayed gastric emptying and may increase the risk of aspiration due to retained gastric contents. There are no guidelines on peri-endoscopic use of GLP-1 RAs, and real-world outcomes in an ambulatory setting remain unknown. This study reports real-world data from an ambulatory center associated with a large tertiary hospital.
View Article and Find Full Text PDFAm J Gastroenterol
November 2024
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
Introduction: Obesity is an increasingly prevalent public health problem often associated with poorly controlled gastroesophageal reflux disease. Fundoplication has been shown to have limited long-term efficacy in patients with morbid obesity and does not address additional weight-related co-morbidities. Roux-en-Y gastric bypass (RYGB) is the gold standard operation for durable resolution of GERD in patients with obesity, and is also used as a salvage operation for GERD after prior foregut surgery.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
November 2022
Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China.
Foregut (foregut exclusions) and hindgut (rapid transit of nutrients to the distal intestine) theories are the most commonly used explanations for the metabolic improvements observed after metabolic surgeries. However, several procedures that do not comprise duodenal exclusions, such as sleeve with jejunojejunal bypass, ileal interposition, and transit bipartition and sleeve gastrectomy were found to have similar diabetes remission rates when compared with duodenal exclusion procedures, such as gastric bypass, biliopancreatic diversion with duodenal switch, and diverted sleeve with ileal interposition. Moreover, the complete exclusion of the proximal intestine could result in the malabsorption of several important micronutrients.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!