Category: Metabolic and Bariatric Surgery

Liraglutide effectively addresses weight regain post-bariatric surgery

A randomized, placebo-controlled trial demonstrated that liraglutide 3.0 mg significantly combats weight regain after Roux-en-Y gastric bypass, with 76% of subjects achieving at least a 5% total body weight loss compared to 17% in the placebo group. Notably, 21% of liraglutide recipients exceeded their postoperative nadir weight. Throughout the study, nonserious adverse events were reported […]

Consensus guidelines established for peri-operative care in obese patients

A modified Delphi process yielded 94 consensus statements on optimising peri-operative care for patients with obesity undergoing non-bariatric surgery. Key pre-operative strategies include access to prehabilitation and risk stratification tools, while intra-operative focus centres on the roles of anaesthetists and surgeons, minimally invasive techniques, and infection prevention. Post-operative care emphasises analgesia, nutritional support, and physiotherapy. […]

Predictive Factors for Postoperative Bleeding Identified

Analysis of nearly 1 million patients revealed specific factors predicting postoperative bleeding after minimally invasive bariatric surgeries. Key predictors identified include preoperative anticoagulation, renal insufficiency, history of deep vein thrombosis (DVT) and pulmonary embolism (PE), presence of a cardiac stent, and a BMI of 40 or less. These associations were consistently observed across both laparoscopic […]

Fat Mass Index Effectively Predicts Weight Loss Post-Surgery

Fat mass index (FMI) significantly predicts early weight loss and quality of life following laparoscopic sleeve gastrectomy (LSG). In a study involving 243 patients, FMI demonstrated superior predictive ability compared to other body composition indicators, with an area under the curve of 0.813. Patients with low FMI experienced greater early eligible weight loss and improved […]

Same-day discharge for anastomotic bariatric surgeries shows promising outcomes

A study involving 208 patients from a high-volume Canadian center assessed early outcomes of same-day discharge (SDD) following various anastomotic metabolic and bariatric surgeries. Results demonstrated low rates of unplanned overnight stays, readmissions, and reinterventions. With a mean patient age of 41.4 years and a preoperative BMI of 41.9 kg/m², these findings suggest that SDD […]

Endoscopic sleeve gastroplasty shows comparable outcomes to surgery

A retrospective analysis of patients undergoing endoscopic sleeve gastroplasty (ESG) versus laparoscopic sleeve gastrectomy (LSG) revealed similar improvements in obesity-related comorbidities. While LSG resulted in greater percentage total body weight loss at 6 months, 1 year, and 2 years, ESG was associated with shorter hospital stays and fewer severe adverse events. Patients undergoing ESG were […]

Machine learning models outperform traditional risk scores in bariatric surgery

Advanced machine learning techniques, particularly random forest, demonstrated superior performance in predicting 30-day complications in metabolic bariatric surgery compared to the established MBSAQIP risk score. The random forest model achieved an area under the receiver operating characteristic curve (AUROC) of 0.94 in training and 0.88 in validation. Key predictive features included serum alkaline phosphatase, platelet […]

Preoperative anticoagulation increases postoperative morbidity in bariatric patients

A recent analysis of 1,178,090 patients reveals that those undergoing sleeve gastrectomy or Roux-en-Y gastric bypass with preoperative therapeutic anticoagulation face significantly higher risks of postoperative complications. Specifically, these patients exhibited increased rates of anastomotic leaks, deep vein thrombosis, and gastrointestinal bleeding, as well as longer operative times and hospital stays. Moreover, sleeve gastrectomy patients […]

Metabolic and bariatric surgery significantly reduces insulin dependency in diabetes.

In a study of 287 patients with insulin-treated type 2 diabetes, metabolic and bariatric surgery (MBS) showed remarkable efficacy. At five years post-surgery, insulin dependence dropped from complete dependency to 36.2%, and the use of non-insulin antidiabetic drugs decreased from 79.4% to 26.1%. Additionally, type 2 diabetes remission rates were highest after biliopancreatic diversion with […]