An international panel reached a consensus on sleeve gastrectomy, endorsing its use for diverse patient populations, including adolescents and the elderly. Key recommendations included avoiding routine dissection of the hiatus and prioritizing endoscopic pigtail drainage for managing acute leaks. Additional surgical options were outlined for patients with severe gastroesophageal reflux disease (GERD) and inadequate weight […]
Category: Metabolic and Bariatric Surgery
Bariatric surgery significantly improves nonalcoholic fatty liver disease outcomes
One year post-bariatric surgery, 80% of patients showed a notable improvement in the nonalcoholic fatty liver disease (NAFLD) activity score. Nonalcoholic steatohepatitis (NASH) improved in 42.1% without worsening fibrosis, and 78.8% experienced fibrosis improvement. MRI-proton density fat fraction (MRI-PDFF) reliably detected liver fat remission in 72.2% to 90.4% of patients, while a significant decline in […]
Bariatric Surgery Safety Improves, But Progress Stalls
Bariatric surgery has significantly enhanced safety, evidenced by a 40% reduction in 90-day mortality over 15 years and declining severe complications. Among 486,161 procedures, sleeve gastrectomy and gastric bypass remain prevalent. However, improvements have plateaued since 2018, signaling a need for fresh optimization strategies. Notably, postoperative medication use has shifted, with analgesic and antidepressant prescriptions […]
Low preoperative serum protein concentration increases staple-line leak risk.
In a study involving 1,669 patients undergoing sleeve gastrectomy, staple-line leaks were significantly associated with low preoperative serum protein concentrations (spc). Patients with leaks had a median spc of 6.8 g/L compared to 7.1 g/L in those without leaks. Higher spc values reduced leak risk (odds ratio of 0.20). Additionally, major intraoperative bleeding and blood […]
Bariatric surgery reduces risks in obese patients with CKD
In a comprehensive study of 5,221 adults with obesity and chronic kidney disease (CKD), bariatric metabolic surgery (BMS) demonstrated a significantly reduced risk of major adverse cardiovascular events, major adverse kidney events, and all-cause mortality over five years. The protective effects of BMS were consistent across all CKD stages but were notably stronger in patients […]
Bariatric surgery significantly lowers healthcare costs within two years
Bariatric surgery yields substantial economic benefits, with total healthcare costs for surgical patients decreasing by an average of $5,677 compared to nonsurgical counterparts within two years. The study examined 18,864 adults, revealing a 22.6% reduction in costs, particularly among those with type 2 diabetes, steatohepatitis, or aged 50-65, who experienced the highest savings. Findings underscore […]
Bariatric surgery improves liver health in MASLD patients
Current findings highlight the efficacy of bariatric surgery in treating metabolic dysfunction-associated steatotic liver disease (MASLD) and its progression to steatohepatitis. The surgical interventions, including Roux-en-Y gastric bypass and sleeve gastrectomy, significantly enhance liver outcomes by reducing steatosis, inflammation, and fibrosis, while lowering cancer risk. These improvements are linked to changes in liver transcriptional programs […]
Reversible endoscopic bypass shows promise for duodenal leaks
A novel procedure, reversible endoscopic gastroduodenal bypass (REGB), demonstrated 100% technical success in six patients with persistent post-surgical duodenal leaks. Patients experienced significant reductions in drain output and resumed oral intake within three days. Following a mean of 52.6 days, five patients successfully underwent REGB reversal, achieving complete healing of ulcers and absence of leaks. […]
Patient characteristics significantly influence readmission rates after metabolic surgery
Key findings reveal that specific patient characteristics, including race, body mass index (BMI), diabetes, chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), and therapeutic anticoagulation, are linked to elevated 30-day readmission rates following metabolic surgery. Notably, black and Hispanic patients showed increased odds of readmission, particularly for multiple readmissions. This large-scale analysis emphasizes the […]
Ursodiol reduces cholecystectomy rates after bariatric surgery
In a study involving 8,433 bariatric surgery patients, ursodeoxycholic acid (UDCA) significantly lowered cholecystectomy incidents. Among the 5,061 patients not receiving UDCA, 2.9% underwent cholecystectomy, compared to just 0.5% of the 3,372 patients treated with 600 mg of UDCA daily for six months. Notably, the rates varied across different surgical types: biliopancreatic diversion with duodenal […]