Gastric HP is not an uncommon diagnosis compared with many other gastric tumors and should more often be considered as a differential diagnosis. Symptom correlation is not always easy to determine, but symptom relief after treatment is well established. An endoscopic ultrasound examination may help when screening patients for extended biopsy and in deciding on which type of operation is to be performed. When treated, minimally invasive techniques should be applied.
In conclusion, although bariatric surgery leads to a greater weight loss at 1 year compared with conservative treatment, in patients with morbid obesity, clinical significant weight loss and similar improvements in risk factors and comorbidities resolution can also be achieved with lifestyle interventions.
SUMMARY BackgroundProton pump inhibitors (PPIs) are potent inhibitors of gastric acid secretion and give hypergastrinemia secondary to gastric hypoacidity. PPI treatment therefore induces enterochromaffin-like (ECL) cell hyperplasia. Longterm hypergastrinemia in rodents and man also leads to ECL cell neoplasia. Whether long-term PPI treatment will induce ECL cell neoplasia in man has been disputed.
The surgeon's performance in MIS can be distinguished from a novice by metrics such as time and path length. An experienced surgeon in MIS can be differentiated from a less experienced one by the higher ability to control the instrument in the nondominant hand and the higher degree of simultaneous (coordinated) movements of the two instruments.
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