European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Case Reports
Laparoscopic sleeve gastrectomy achieves substantial weight loss in an adolescent girl with morbid obesity.
The European guidelines for bariatric surgery clearly define criteria for operating children with morbid obesity. However the appropriate technique for this age-group has not been identified yet. So far gastric banding and Roux-Y bypass represent the standards, but they demand life-long tolerance of either an artificial device or significant malabsorption. Although laparoscopic sleeve gastrectomy (LSG) demands neither, it has not been advocated for this age-group as a stand-alone technique. We report the outcome and the rationale for this approach in a 16-year-old girl with morbid obesity. ⋯ LSG is a safe and effective option for bariatric surgery in obese adolescents. It can be offered as a stand-alone restrictive operation and could be extended to a malabsorptive procedure at any time. However longer follow-up is required before universally recommending this procedure.
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The aim of this study was to investigate latent manganese toxicity in patients with biliary atresia and to use this tool to predict the prognosis of biliary atresia patients after Kasai's portoenterostomy. ⋯ Although the study size is small, it shows that there is a risk of latent manganese toxicity in patients with biliary atresia who have undergone Kasai's portoenterostomy. Whole blood manganese assay in conjunction with brain MRI can be used to serially monitor these patients for early detection of these complications. This tool can be used for prognosis after Kasai's portoenterostomy and can also be extremely useful in selecting patients who will need a liver transplant on a priority basis.