Standard vs Distal Roux-en-Y Gastric Bypass in Patients With Body Mass Index 50 to 60

Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon; Hjelmesæth, Jøran; Aasheim, Erlend T.; Hofsø, Dag; Søvik, Torgeir T.; Karlsen, Tor-Ivar; Fagerland, Morten Wang; Sandbu, Rune; Mala, Tom

doi:10.1001/jamasurg.2016.2798

Cited by 58 publications

(46 citation statements)

References 47 publications

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“…Surveillance and Treatment of Dyslipidaemia after Bariatric Surgery: On average, serum total-cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides decline during the first 6 weeks after gastric bypass [66,73]. Several studies demonstrated that the LDL-cholesterol and triglyceride levels were reduced until 1 year and then stabilized in parallel with the period of maximum weight loss (1-2 years), while HDL-cholesterol increases from 6 weeks to 1-2 years above the baseline level [66,73].…”

Section: Management Of Co-morbiditiesmentioning

confidence: 99%

“…Several studies demonstrated that the LDL-cholesterol and triglyceride levels were reduced until 1 year and then stabilized in parallel with the period of maximum weight loss (1-2 years), while HDL-cholesterol increases from 6 weeks to 1-2 years above the baseline level [66,73]. In general, the proportion of patients taking lipid-lowering drugs after bariatric surgery tends to reduce [74].…”

Section: Management Of Co-morbiditiesmentioning

confidence: 99%

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Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.

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Section: Management Of Co-morbiditiesmentioning

confidence: 99%

Section: Management Of Co-morbiditiesmentioning

confidence: 99%

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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“…The distal RYGB used in this study had a short common channel (distance from the entero-entero anastomoses to the ileocecal valve). We have previously shown that this variant of distal RYGB was associated with a higher prevalence of secondary hyperparathyroidism than standard RYGB [18]. To our knowledge, the effects of distal RYGB on bone turnover markers have not been reported.…”

Section: Introductionmentioning

confidence: 87%

“…Glucagon-like peptide 1 (GLP-1) and peptide tyrosine tyrosine (PYY) have been shown to have direct effects on bone metabolism, where GLP-1 has an insulin-independent anabolic effect on bone, and PYY direct effects inhibiting osteoblasts [9]. Distal gastric bypass leads to lower glucose, HbA1c, and LDL cholesterol despite similar weight loss, potentially indicating different effects on bile acids or gut hormones [18], but further studies are needed to investigate this.…”

Section: Possible Mechanisms and Explanationsmentioning

confidence: 99%

Bone Turnover Markers After Standard and Distal Roux-en-Y Gastric Bypass: Results from a Randomized Controlled Trial

et al. 2019

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Background Roux-en-Y gastric bypass is associated with increased risk of bone fractures. Malabsorptive procedures may be associated with secondary hyperparathyroidism and detrimental effects on bone health. We aimed to compare the effects of standard and distal gastric bypass on bone turnover markers 2 years after surgery. Methods Patients with body mass index (BMI) 50-60 kg/m 2 (n = 113) were randomized to standard or distal gastric bypass, 105 patients (95%) completed 2-year follow-up. Serum C-terminal telopeptide of type I collagen (CTX-1), procollagen type I Npropeptide (PINP), and bone-derived alkaline phosphatase (BALP) was measured at baseline and up to 2 years after surgery. ANCOVA and linear mixed models were used to compare groups. Results The levels of bone turnover markers increased significantly in both groups, with no statistically significant difference between groups. Two years after standard and distal gastric bypass mean (SD) CTX-1 were 0.81 (0.32) and 0.83 (0.31) μg/L (p = 0.38), mean PINP was 77.6 (23.2) and 77.7 (29.3) μg/L (p = 0.42), and BALP 47.9 (21.9) vs. 50.7 (19.6) μg/L (p = 0.38), respectively. Multiple linear regression analyses showed that PINP and BALP correlated positively (p = 0.01 and p < 0.001) with PTH, but only BALP was significantly higher in patients with secondary hyperparathyroidism (p = 0.001). Type of surgery, vitamin D serum concentrations, and 2-year BMI were all independently associated with PTH levels.

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“…Many studiesconcur that the CL length and AL length do not affect the amount of potential weight loss that a patient can achieve [25][26][27][28] though Tran et al [29] has suggested the use of a distal bypass is an effective revision for a failed loss of weight on a standard bypass. There is certainly a range of results on whether proximal or distal bypasses have more pronounced effects on the metabolic and endocrine systems as reported by Risstad et al [9] and Ramos et al [30] Distal bypasses may also be related to increased rates of complication.…”

Section: Authors' Contributionsmentioning

confidence: 95%

The influence of total bowel length on gastric bypass outcomes

Quan¹,

Cooper²,

Bekheit³

2017

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Standard vs Distal Roux-en-Y Gastric Bypass in Patients With Body Mass Index 50 to 60

Abstract: Clinicaltrials.gov Identifier: NCT00821197.

Cited by 58 publications

References 47 publications

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Bone Turnover Markers After Standard and Distal Roux-en-Y Gastric Bypass: Results from a Randomized Controlled Trial

The influence of total bowel length on gastric bypass outcomes

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