Obesity surgery
-
Comparative Study
Markers of bone and calcium metabolism following gastric bypass and laparoscopic adjustable gastric banding.
Several studies have suggested that morbid obesity is associated with vitamin D deficiency and elevated parathyroid hormone (PTH). Studies have also suggested that there is an increase in vitamin D deficiency, bone resorption, and elevated PTH after gastric bypass surgery. Few studies have evaluated markers of bone and calcium metabolism after laparoscopic adjustable gastric banding or compared these results to those after gastric bypass. ⋯ These findings suggest that morbid obesity is associated with vitamin D deficiency, and elevated PTH and with adequate supplementation, GBP, and particularly LAGB, patients can improve their bone metabolism abnormalities related to obesity. Furthermore, adequate supplementation for GBP patients may attenuate the increased risk for bone loss associated with malabsorption from the bypass.
-
Restrictive bariatric procedures are frequently considered for patients with morbid obesity, because the weight loss and reduction of comorbidities are good. An impact on gastroesophageal reflux disease (GERD), which is common in this population, may be anticipated. Converse results of GERD symptoms are reported for patients after adjustable gastric banding (AGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGBP). ⋯ Preoperative esophageal manometry is advised for restrictive procedures such as AGB and SG.
-
Clinical Trial
Continuous hemodynamic monitoring during laparoscopic gastric bypass in superobese patients by pressure recording analytical method.
Morbid obesity, compromising cardiovascular and respiratory function, may increase the risk of anesthesia and was initially considered a contraindication to laparoscopy. The aim of this study was to investigate hemodynamic effects induced by pneumoperitoneum in superobese patients, assessed by arterial pulse contour method. ⋯ As assessed by PRAM, this study showed no deterioration in hemodynamic indices or ventricular performance during laparoscopic gastric bypass.
-
Nonalcoholic steatohepatitis (NASH) and gallbladder disease (GD) are members of metabolic syndrome in morbidly obesity. Insulin resistance is a risk factor for NASH and GD. The aim of the present study was to investigate the relationship between insulin resistance (HOMA-IR), liver fibrosis, NASH and GD in morbidly obese patients who presented with fatty liver during preoperative abdominal ultrasonography examination. ⋯ The prevalence of NASH in gallbladder disease was 18% in morbid obese population. We concluded that age, serum cholesterol, and low-density lipoprotein cholesterol levels were risk factors associated with gallbladder disease and fatty liver disease. Insulin resistance was more common in concurrent NASH and gallbladder disease. The mechanism between insulin resistance, fibrosis stage, NASH, and gallbladder disease is unknown.