Background
Despite consistent interest over the past 2 decades regarding the metabolic effects of body contouring (BC), previous studies are limited by short follow-up periods, small sample sizes, gender-specific cohorts, and assessment of all anatomic regions together.
Objectives
This study evaluates the changes in glucose and lipid levels over long-term follow-up after trunk-based BC and compares postbariatric with non-bariatric patients.
Methods
The retrospective cohort study included patients who underwent trunk-based BC from January 1, 2009 through July 31, 2020 at West Virginia University. A minimum 12-month follow-up was required for inclusion. With BC surgery as the reference point, patients’ glucose, hemoglobin A1c, and lipid levels were assessed prior to surgery and at long-term follow-up. Change over time was compared between postbariatric and non-bariatric cohorts. Multivariable linear regression models were performed to assess the effect of potential confounding variables on the difference between cohorts.
Results
Seventy-seven BC patients had glucose levels evaluated during the study period, and 36 had lipid profiles obtained. Average follow-up from date of BC was 41.2 months for the patients with glucose follow-up and 40.9 months for those with lipid levels. From pre-BC to endpoint follow-up, glucose levels mildly increased in all patients. Multivariable linear regression models accounting for age showed non-bariatric patients experience significantly improved total cholesterol levels compared to postbariatric patients (p = 0.0320). Weight loss maintained following BC was not associated with significant differences between cohorts.
Conclusions
Fasting glucose levels marginally increase in most BC patients through follow-up. Non-bariatric patients generally experience more favorable changes in lipid profile following trunk-based BC than do postbariatric patients.
Gallstone ileus is an uncommon cause of intestinal obstruction in the elderly. It is typically recognized on computed tomography by the presence of pneumobilia and a gallstone in the right iliac fossa. Nonetheless, it is important to consider that gallstone ileus may represent the presentation of another pathology rather than an entity on its own. Here, we report successful retrieval of a gallstone that was causing ileus. Intraoperatively, the gallstone was noted lodged in the terminal ileum distal to an incidentally noted Meckel's diverticulum. The gallstone was milked proximally into the Meckel's diverticulum and the base was transected. This case illustrates a rare, but unique, surgical technique utilizing a small bowel diverticulum as a vector for stone removal.
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