Fatores preditivos de colelitíase em obesos mórbidos após astroplastia em Y de Roux

Taha, Mohamed Ibrahin Ali; Freitas, Wilson Rodrigues de; Puglia, Carlos Roberto; Lacombe, A; Malheiros, Carlos Alberto

doi:10.1590/s0104-42302006000600024

Cited by 14 publications

(15 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Para Lehmann et al (2006), as considerações de Taha et al (2006) fizeram-se Brazilian Journal of health Review presentes entre os pacientes analisados, inexistindo associação entre os fatores acima mencionados. Notou-se, adicionalmente, perda de peso significativamente superior no grupo de pacientes que desenvolveram colelitíase.…”

Section: Estudos Comparativosunclassified

Colelitíase assintomática em pacientes submetidos à gastroplastia: Uma revisão da literatura

Oliveira

Dantas

Souki

et al. 2020

BJHR

View full text Add to dashboard Cite

Pacientes submetidos à gastroplastia, pela técnica Capella ou Sleeve, têm retornado ao centro cirúrgico de referência para a realização de exames de imagem para verificação da existência de cálculos biliares de vesícula, ainda que não apresentem queixas a respeito. Analisando-se as considerações pós-operatórias após cirurgia bariátrica e características acerca da obesidade, analisa-se neste estudo, percentuais consideráveis a fim de revisar a literatura acerca do tema para propor melhores práticas preventivas ao paciente.

show abstract

Section: Estudos Comparativosunclassified

Colelitíase assintomática em pacientes submetidos à gastroplastia: Uma revisão da literatura

Oliveira

Dantas

Souki

et al. 2020

BJHR

View full text Add to dashboard Cite

show abstract

“…After re-inflating the balloon, the stones are pushed forward through the dilated sphincter into the duodenum. 1,80,81 If the stone size exceeded 10 mm, mechanical lithotripsy with Dormia basket is recommended. 82 The stone fragments are then evacuated into the duodenum by using the balloon catheter or Dormia basket (Fig.…”

Section: Choledocholithiasismentioning

confidence: 99%

“…Furthermore the treatment can be challenging because of the anatomical changes due to the bariatric procedure. 1,2 Diverse kinds of protocols exist: prophylactic surgery (simultaneous cholecystectomy and gastric bypass in every patients, whether they have or not cholelithiasis), 3,4 elective (simultaneous cholecystectomy with conventional gastric bypass in the patients with asymptomatic cholelithiasis), [5][6][7] and conventional cholecystectomy only in the presence of cholelithiasis with symptoms. [8][9][10][11] The incidence of cholelithiasis post gastric bypass is estimated around 37%.…”

mentioning

confidence: 99%

“…Recent trend analysis in gastric bypass patients suggests that concomitant cholecystectomy should be considered only in symptomatic gallstones. 1,9,31,40,41 The use of ursodeoxycholic acid (UDCA) also has been proposed as a preventive measure for the gallstone formation. The UDCA is a bile acid that dissolves gallstones by decreasing biliary cholesterol secretion to lower bile cholesterol saturation and by decreasing biliary glycoprotein secretion to lower biliary nucleating factors.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Gallbladder stones in bariatrics and management of choledocholithiasis after gastric bypass

Palermo

Neto²

2019

Gastrointestinal Intervention

View full text Add to dashboard Cite

It is known that the rapid weight loss is a predisposing factor to develop biliary lithiasis. The physiopathology is related with an oversaturation of bile with cholesterol, bile stasis, and increase in mucin concentration in bile. The incidence of cholelithiasis post gastric bypass is estimated around 37%. Almost 50% developed disease in the first year of monitoring, and 60% in the first 6 months. Meanwhile the patients undergoing sleeve gastrectomy have an incidence of cholelithiasis of 27%. Diverse kinds of protocols exist: prophylactic surgery (simultaneous cholecystectomy and gastric bypass in every patients, whether they have or not cholelithiasis), elective (simultaneous cholecystectomy with conventional gastric bypass in the patients with asymptomatic cholelithiasis), and conventional cholecystectomy only in the presence of cholelithiasis with symptoms. Which way to go is still a topic of discussion among surgeons but the majority agree that prophylactic surgery shouldn't be an option because the number of patients that will develop symptomatic cholelithiasis is low (around 6% to 8% of them) and this leads to an elevated number of patients exposed to an unnecessary procedure with potential complications. The presence of gallstones in the common bile duct (CBD) although is a rare complication after Roux-en-Y gastric bypass (around 0.2% of the bariatric patients) represents an important challenge due to the anatomical modifications of the gastrointestinal tract. This leads to having to pursue other methods to reach the papillae for the resolution of choledocholithiasis: laparoscopyassisted transgastric endoscopic retrograde cholangiopancreatography (ERCP), balloon enteroscopy assisted ERCP, percutaneous biliary drainage with subsequent trans fistula treatment and laparoscopic exploration of CBD. Which of these methods should we choose must be based on the surgeon experience, the equipment available and the location of the stone. But whatever the method, a special training is needed on endoscopy, percutaneous surgery and laparoscopy.

show abstract

“…La anastomosis gastrointestinal en Y-de-Roux es una técnica de reconstrucción del tránsito intestinal creada para desviar la secreción biliopancreática e impedir su refl ujo al estómago 1,2 . La pandemia de la obesidad posicionó al bypass gástrico en Y-deRoux (BGYR) como uno de los procedimientos quirúrgicos más empleados para tratar esta enfermedad 3 .…”

Section: Introductionunclassified

Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

et al. 2012

View full text Add to dashboard Cite

Endoscopic retrograde cholangiopancreatography in Roux-en-Y patientsThe reconstruction of the digestive tract with a Roux-en-Y anastomosis has been performed more frequently in the last years mainly due to the overgrowth in the surgical treatment of obesity by gastric bypass in Roux-en-Y. The obesity pandemic is also associated with an increase in both the preoperative and postoperative diagnosis of gallstones in this population. Bearing in mind the greater complexity of endoscopic retrograde cholangiopancreatography in these circumstances, the authors have reviewed the various endoscopic approaches available, evaluating 249 articles published between 1990 and 2010 obtained from Medline, Cochrane and Scielo, excluding case reports and articles outside the specifi c scope of this study. Endoscopic techniques with high success rates include the use of enteroscope, colonoscope, enteral and transgastric access combined with surgery. Even with the technological progress already made, further development of the instruments used will be necessary if greater comfort and safety is to be achieved with this procedure.Key words: Choledocholithiasis (MeSH), Anastomosis, Roux-en-Y (MeSH), Gastric Bypass (MeSH), Cholangiopancreatography, Endoscopic Retrograde (MeSH). ResumenLa reconstrucción del trato digestivo con un asa en Y-de-Roux ha sido más empleada en los últimos años debido principalmente al aumento del tratamiento quirúrgico de la obesidad mediante el bypass gástrico en Y-de-Roux (BGYR). La pandemia de la obesidad se ha asociado a un aumento en la prevalencia de litiasis biliar en esta población, diagnosticada en el estudio preoperatorio y durante el seguimiento postoperatorio. La colangiopancreatografía endoscópica retrógrada (CPRE) posee una mayor complejidad en estas circunstancias donde existe una alteración anatómica que difi culta el acceso a la papila mayor. El objetivo de esta revisión es describir las alternativas de acceso al asa biliopancreática para realizar CPRE en pacientes con un asa en Y-deRoux enfatizando la accesibilidad técnica, los resultados y complicaciones de los procedimientos. Se realizó una búsqueda y revisión de la literatura en las bases de datos: Medline, Cochrane y Scielo. Se evaluaron 249 publicaciones desde 1990 a 2010, en idioma español, inglés y portugués. Fueron excluidos de esta revisión los reportes de casos y publicaciones no atingentes. Las opciones endoscópicas para realizar CPRE en pacientes Rev.

show abstract

Fatores preditivos de colelitíase em obesos mórbidos após astroplastia em Y de Roux

Cited by 14 publications

References 12 publications

Colelitíase assintomática em pacientes submetidos à gastroplastia: Uma revisão da literatura

Colelitíase assintomática em pacientes submetidos à gastroplastia: Uma revisão da literatura

Gallbladder stones in bariatrics and management of choledocholithiasis after gastric bypass

Colangiopancreatografía retrógrada endoscópica en pacientes con asa en Y-de-Roux

Contact Info

Product

Resources

About