Percutaneous Gastrostomy for Treating Dilatation of the Bypassed Stomach After Bariatric Surgery for Morbid Obesity

Nosher, John L.; Bodner, Leonard; Girgis, Wahid S.; Brolin, Robert E.; Siegel, Randall L.; Gribbin, C

doi:10.2214/ajr.183.5.1831431

Cited by 41 publications

(32 citation statements)

References 12 publications

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“…Radiographically guided gastric remnant access techniques using ultrasound, fluoroscopy, and computed tomography are well described [6,7] and minimally invasive; however, the complication rate in this population is undesirably high. In a recent series of eight patients treated with radiographically placed remnant GTs, Nosher reported a complication rate of 25%, with one patient requiring surgical intervention for peritonitis [6].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Gastrostomy After Bariatric Surgery: A Unique Approach

2009

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Gastrostomy tube placement after Roux-en-Y gastric bypass can be challenging, particularly in patients with dense abdominal adhesions. Novel, minimally invasive approaches are needed to access the gastric remnant when needed. We present an innovative method for gastrostomy tube placement in a patient with a retrocolic gastric bypass using a combined endoscopic ultrasound and fluoroscopy-guided approach, describing the essential technical steps of the procedure.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Gastrostomy After Bariatric Surgery: A Unique Approach

2009

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“…Biopsies can also be taken [4,5]. Some authors even suggest the insertion of a temporary gastrostomy tube and radio opaque marker on the anterior aspect of the gastric remnant at the time of gastric bypass to facilitate future access [6].…”

Section: Discussionmentioning

confidence: 99%

Perforated Duodenal Ulcer After Laparoscopic Gastric Bypass

et al. 2008

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A patient with a history of a laparoscopic gastric bypass presented with a perforated duodenal ulcer. The ulcer was laparoscopically oversewn, and an omentoplasty was performed. Postoperatively, a broad spectrum antibiotic and a proton pump inhibitor were administrated. Several questions arise regarding the diagnosis and treatment of duodenal ulcers after gastric bypass. What are the diagnostic tools to detect a duodenal ulcer, and how should Helicobacter pylori be diagnosed after gastric bypass? The key question is whether the bypassed stomach should be resected as a definitive treatment for complicated duodenal ulcers.

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“…105 When faced with starvation, the body's response should be protein sparing, using fat catabolism and ketosis to generate energy while attempting to spare lean body mass. Hypoalbuminemia is considered a late outcome of starvation, yet it is often found early in bariatric patients who have not lost substantial body weight.…”

Section: Protein Malnutritionmentioning

confidence: 99%

“…The gastrostomy either can be placed into the excluded pouch laparoscopically or, in some cases, done percutaneously under CT guidance. 105 Very few patients require the institution of total parental nutrition. Monitoring of serum phosphate, calcium, and magnesium should be instituted to avoid refeeding deficiencies.…”

Section: Protein Malnutritionmentioning

confidence: 99%

Surgery for Obesity: A Review of the Current State of the Art and Future Directions

McNatt

Longhi

Goldman

et al. 2007

Journal of Gastrointestinal Surgery

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The number of patients undergoing surgery for the treatment of obesity, and the proportion of the health care budget dedicated to this health problem, is growing exponentially. There are several competing surgical approaches for the management of morbid obesity. We review the literature relating to four of these: gastric bypass, biliopancreatic diversion, gastric banding, and gastric pacing. Our review finds that while enhancing the malabsorptive activity of these procedures may induce an incremental increase in excess body weight loss, the proportion of patients who fail to lose more than 50% of their excess body weight is similar no matter how radical is the surgery performed. There is little guidance from the literature as to appropriate patient selection for the varying procedures, and anonymously reported registries have yet to show that patients who undergo bariatric surgery have enhanced longevity. To date, the bariatric surgical community has not conducted adequately powered randomized prospective trials to elucidate key elements of the surgical procedure such as optimal bypass length, to determine whether mixed operations are superior to those that offer intake restriction only, and to define what constitutes success after bariatric surgery. As a public health measure, bariatric surgery in the United States is being pursued in an irrational manner, being concentrated in areas where there are fewer morbidly obese patients, and used disproportionately among the population of white obese females.

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Percutaneous Gastrostomy for Treating Dilatation of the Bypassed Stomach After Bariatric Surgery for Morbid Obesity

Cited by 41 publications

References 12 publications

Endoscopic Gastrostomy After Bariatric Surgery: A Unique Approach

Endoscopic Gastrostomy After Bariatric Surgery: A Unique Approach

Perforated Duodenal Ulcer After Laparoscopic Gastric Bypass

Surgery for Obesity: A Review of the Current State of the Art and Future Directions

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