Sleeve Gastrectomy — A Restrictive Procedure?

Melissas, John; Koukouraki, S.; Askoxylakis, John; Stathaki, Maria; Daskalakis, Markos; Perisinakis, Kostas; Karkavitsas, N.

doi:10.1007/s11695-007-9006-5

Cited by 356 publications

(244 citation statements)

References 20 publications

(30 reference statements)

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“…Its discovery has shed new light on many physiological functions. Among the several actions of this peptide in the human body, ranging from its involvement in the regulation of the immune and cardiovascular systems to the up-regulation of insulin-like growth factor, it has a dominant role in the gastrointestinal system, with involvement in gastric emptying and intestinal motility (10)(11)(12)(13)(14).…”

mentioning

confidence: 99%

Ghrelin and Obesity: Identifying Gaps and Dispelling Myths. A Reappraisal

Makris

Alexandrou

Papatsoutsos

et al. 2017

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Abstract. The etiology of obesity is complex. Environmental and genetic causes have been implicated in the development of this disease. Ghrelin is a hormoneObesity is a major public health problem as more than 10% of the global population is obese (1). The number of patients affected by this modern epidemic and the associated comorbidities, such as diabetes mellitus, cardiovascular diseases and cancer, are constantly rising, along with the associated health costs, making the management of obesity one of paramount importance (2, 3).There are mainly two ways to manage obesity: the conservative one (e.g. diet, exercise and lifestyle changes) and the surgical approach through various weight-loss surgical procedures, widely known as bariatric surgery.Surgery not only leads to malabsorption (calories are not taken up by the intestine), mechanical restriction (less room for food), but also to hormonal changes that lead to less hunger or earlier satiety postprandially (3, 4).During the past couple of decades the identification of circulating factors that contribute to the induction of hunger (orexigenic) or satiety (anorexigenic) has diversified the cause of food restriction after bariatric surgery apart from being solely a mechanical phenomenon to a more complex effect of both anatomical and humoral modifications induced by the different operative strategies.Ghrelin is a well-known orexigenic hormone that stimulates food intake in a dose-dependent manner (5-8). Ghrelin increases appetite both by initiating homeostatic feeding driven by metabolic need and by non-homeostatic feeding, acting centrally and affecting the modulation of reward, memory and motivated feeding behavior (9).In this review, we planned to highlight the available data regarding the appetite-generating effect of ghrelin. We searched the literature in order to find determinants with a proven direct positive feedback in appetite.

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mentioning

confidence: 99%

Ghrelin and Obesity: Identifying Gaps and Dispelling Myths. A Reappraisal

Makris

Alexandrou

Papatsoutsos

et al. 2017

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“…Leaks and bleeding represent the most feared complications and the most frequently reported causes of death after LSG. Reported leak rates range from 0.7 to 5.3% [24,41,[44][45][46]50]. Esophageal stenting (endoluminal technique) is an effective and new strategy for treatment of gastric fistula, and may be performed safely in a patient with leak of the staple line following sleeve or re-sleeve gastrectomy (for weight regain) with or without BPD-DS [53,54].…”

Section: Discussionmentioning

confidence: 99%

“…Hould et al [23] reported a hastened gastric emptying in patients who underwent BPD-DS as compared to controls and BPD. Recently, Melissas et al [24] reported the results of antrum functionality in patients who underwent SG. Those results have added some important details to the mechanism involved in SG to achieve weight loss.…”

Section: Mechanism Of Action Of Sleeve Gastrec-tomymentioning

confidence: 99%

Updated Review of Sleeve Gastrectomy

Trelles¹,

Gautier²

2008

TOGASJ

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There is a bariatric explosion worldwide to deal with the rising prevalence of morbid obesity. In 1988, Hess and Hess first added the sleeve gastrectomy (SG) and the duodenal switch (DS) as a modification to the biliopancreatic diversion (BPD) to improve clinical outcomes. But the increased morbidity and mortality observed in super-super-obese patients (BMI > 60 kg/m ) who underwent BPD with DS (BPD-DS) made Gagner and co-workers propose SG as a bridge to gastric bypass or BPD-DS to reduce complications and mortality. The excellent short-term weight-loss outcomes after SG have increased the enthusiasm among surgeons to use it as a definitive treatment for morbidly obese and super-obese patients (BMI > 50 kg/m ). Neurohormonal and gastric emptying changes may account for its superiority over other restrictive procedures. Recent reports on mid-term weight-loss outcomes make this procedure a viable option for bariatric surgeons; nonetheless, long-term studies are still required.

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“…An increased risk of hematoma developing and abscess formation is found as a result. Early bleeding through drains or NG tube is called a sentinel bleed and it usually can occur within hours of surgery [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%