C-Reactive Protein 2 Days After Laparoscopic Gastric Bypass Surgery Reliably Indicates Leaks and Moderately Predicts Morbidity

Warschkow, René; Tarantino, Ignazio; Folie, P.; Beutner, Ulrich; Schmied, Bruno M.; Bisang, Philipp; Schultes, Bernd; Thurnheer, Martin

doi:10.1007/s11605-012-1882-x

Cited by 53 publications

(32 citation statements)

References 41 publications

(59 reference statements)

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“…-Early detection and adequate treatment of gastrointestinal (GI) leaks in suspected patients (newly sustained tachycardia > 120 pulses/min for at least 6 h, fever, tachypnoea, newly established signs of hypoxia, increasing pain, elevated C-reactive protein) through upper GI X-ray or CT studies. Surgical revision (laparoscopy or laparotomy) may be considered and is justified in case of highly clinically suspicious cases, despite non-presence of some of the symptoms and/or even in negative upper GI studies (EL C [197][198][199][200] ). All patients after bariatric procedures require regular lifelong qualified surveillance.…”

Section: Follow-upmentioning

confidence: 99%

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

et al. 2013

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In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity -European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.

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Section: Follow-upmentioning

confidence: 99%

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

et al. 2013

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“…The C-reactive protein (CRP) values were shown to be a more sensitive parameter than leucocyte count when suspecting a leakage. Therefore, CRP during the first postoperative days should be closely monitored, preferably on days 2 and 4 after the operation [42]. The diagnostic tools of choice are computed tomography with oral and intravenous contrast as well as endoscopy.…”

Section: Resultsmentioning

confidence: 99%

Gastric Bypass: Current Results and Different Techniques

Vines¹,

Schiesser²

2014

Dig Surg

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Obesity has been steadily increasing over the last three decades and is one of the leading causes of increased health costs due to its associated comorbidities. Unfortunately, conservative treatment including lifestyle changes did not achieve the desired results. Bariatric surgery, on the other hand, has emerged as an effective and safe treatment for obesity and its related comorbidities such as type 2 diabetes. Much time has passed since the first Roux-en-Y gastric bypass was performed in the 1960s, and the operation technique has since evolved. New variations such as the distal gastric bypass as well as the omega loop bypass have been developed. Today, the laparoscopic gastric bypass is still the most widely applied bariatric operation technique, followed by laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding. The refinement of the surgical technique and the introduction of laparoscopy have resulted in low perioperative morbidity and mortality after gastric bypass surgery. In this article, we will be discussing the history of gastric bypass surgery as well as presenting current data on excessive weight loss and resolution of comorbidities with a focus on diabetes. We will be looking into newer techniques such as omega loop bypass and their efficacy compared to the standard gastric bypass. Furthermore, we will be addressing the most important early and long-term complications, their diagnostic strategies as well as their management.

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“…Discharge at postoperative D1 should be allowed depending on white blood cells count <17,000 and serum CRP <100 [33,34] as well as physiological vital parameters, absence of nausea and vomiting, adequate food intake, and adequate pain control [15].…”

Section: Discussionmentioning

confidence: 99%