Obesity Surgery: Evidence for Diabetes Prevention/Management

Cummings, Sue; Apovian, Caroline M.; Khaodhiar, Lalita

doi:10.1016/j.jada.2008.01.017

Cited by 32 publications

(21 citation statements)

References 25 publications

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“…Preoperative HbA1c appears to be predictive for remission of T2D in many studies [4,10,22] since poorly controlled diabetes will be less sensitive to the improvement in insulin response post-surgery, given the probable pre-existing deficit in secretion by B-cells in the pancreas [36][37][38][39][40][41][42]. Our data are similar to those published previously, without significant superiority of the group with wellcontrolled diabetes pre-surgery.…”

Section: Discussionsupporting

confidence: 87%

Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity

et al. 2015

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Section: Discussionsupporting

confidence: 87%

Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity

et al. 2015

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“…A reduction in fat mass that occurs with weight loss results in reduction of lipid oxidation and enhancement of glucose metabolism [24]. Insulin secretion and plasma insulin concentrations have been shown to decrease substantially after weight loss [25].…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes

et al. 2009

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“…However, double-balloon endoscopy has shown to be useful not only for enteroscopy, but also for difficult colonoscopy, and case series illustrated successful ERCP after Roux-en-Y reconstructive surgery of the small bowel [7,8,9,10,11,12,16]. Since obesity has become an endemic pathology both in the USA and in Europe, bariatric surgery is increasingly performed as a treatment of morbid obesity and its complications [17,18,19]. In our university hospital, the laparoscopic Roux-en-Y gastric bypass with or without robot assistance is the surgical approach of choice for treating morbid obesity [19].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Double-Balloon Enteroscopy after Small Bowel Roux-en-Y Reconstructive Surgery

Moreels¹,

Hubens²,

Ysebaert

et al. 2009

Digestion

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Background: Roux-en-Y reconstruction excludes the afferent limb and the biliopancreatic system from conventional endoscopic access. Postoperative problems in these excluded gastrointestinal systems are therefore often dealt with surgically. We investigated the usefulness of the therapeutic double-balloon enteroscope to perform interventional endoscopic procedures in the excluded segment of the gastrointestinal tract after Roux-en-Y reconstruction. Methods: 30 procedures were performed in 22 patients with Roux-en-Y reconstruction after enterobiliary anastomosis, gastrectomy or bariatric gastric bypass. All procedures were performed with the therapeutic double-balloon enteroscope, under general anesthesia and with fluoroscopic control. Results: ERCP at the enterobiliary anastomosis was successful in 90% (n = 10) of the procedures. ERCP at the intact papilla was successful in 60% (n = 5). Enterocutaneous fistula closure after (sub)total gastrectomy was performed in 2 procedures. Successful diagnostic procedures encompassed intubation of the excluded stomach after bariatric gastric bypass (89%, n = 9) or the afferent limb after Roux-en-Y reconstruction (75%, n = 4). The overall success rate in accessing the aimed excluded segment with the double-balloon enteroscope was 87%. Interventional procedures were able to avoid surgery in 65%. One retroperitoneal perforation occurred during ERCP which was conservatively treated. Conclusions: Excluded gastrointestinal segments after Roux-en-Y reconstruction can be accessed with a substantial success rate using double-balloon enteroscopy. Therapeutic interventions like ERCP can prevent surgery in the majority of patients.

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Obesity Surgery: Evidence for Diabetes Prevention/Management

Cited by 32 publications

References 25 publications

Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity

Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity

Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes

Diagnostic and Therapeutic Double-Balloon Enteroscopy after Small Bowel Roux-en-Y Reconstructive Surgery

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