scholarly journals Concomitant versus Delayed Cholecystectomy in Bariatric Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hatem Elgohary ◽  
Mahmoud El Azawy ◽  
Mohey Elbanna ◽  
Hossam Elhossainy ◽  
Wael Omar
Keyword(s):  
Bariatric Surgery ◽  
Close Association ◽  
Gallbladder Disease ◽  
Objective Evaluation ◽  
Biliary Colic ◽  
Delayed Cholecystectomy ◽  
Asymptomatic Patients ◽  
Group 2 ◽  
Difficulty Score ◽  
Group 1

Background. Obesity and weight loss after bariatric surgery have a close association with gallbladder disease. The performance and proper timing of laparoscopic cholecystectomy (LC) with bariatric surgery remain a clinical question. Objective. Evaluation of the outcome of LC during bariatric surgery whether done concomitantly or delayed according to the level of intraoperative difficulty. Methods. The prospective study included patients with morbid obesity between December 2018 and December 2019 with preoperatively detected gallbladder stones. According to the level of difficulty, patients were allocated into 2 groups: group 1 included patients who underwent concomitant LC during bariatric surgery, and group 2 included patients who underwent delayed LC after 2 months. In group 1, patients were further divided into subgroups: LC either at the beginning (subgroup A) or after bariatric surgery (subgroup B). Results. Operative time in group 1 vs. 2 was 92.63 ± 28.25 vs. 68.33 ± 17.49 ( p < 0.001 ), and in subgroup A vs. B, it was 84.19 ± 19.62 vs. 130.0 ± 31.62 ( p < 0.001 ). One patient in each group (2.6% and 8.3%) had obstructive jaundice, p > 0.001 . In group 2, 33% of asymptomatic patients became symptomatic for biliary colic p > 0.001 . LC difficulty score was 2.11 ± 0.70 vs. 5.66 ± 0.98 in groups 1 and 2, respectively, p < 0.001 . LC difficulty score decreased in group 2 from 5.66 ± 0.98 to 2.26 ± 0.78 after 2 months of bariatric surgery, p < 0.001 . Conclusion. Timing for LC during bariatric surgery is challenging and should be optimized for each patient as scheduling difficult LC to be performed after 2 months may be an option.

scholarly journals Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

2020 ◽  
Vol 30 (8) ◽  
pp. 3073-3083 ◽  
Author(s):  
Walid El Ansari ◽  
Ayman El-Menyar ◽  
Brijesh Sathian ◽  
Hassan Al-Thani ◽  
Mohammed Al-Kuwari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Publication Bias ◽  
Surgical Approach ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

scholarly journals When to resume bariatric surgery after COVID-19 pandemic?: results of patients’ and surgeons’ survey

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alicja Dudek ◽  
Michał Wysocki ◽  
Maciej Walędziak ◽  
Jacek Szeliga ◽  
Monika Proczko-Stepaniak ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
World Health ◽  
Online Surveys ◽  
The World ◽  
Bariatric Patients ◽  
Group 2 ◽  
Health Organization ◽  
Current Body Mass Index ◽  
Group 1

Abstract Background Coronavirus Disease 2019 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state. Methods The study was conducted in two groups: Group 1—bariatric patients; Group 2—bariatric surgeons. Two online surveys were distributed. Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p < 0.001) and contact with COVID+/quarantined persons (p < 0.001) had impact on the response to resumption of bariatric procedures. Conclusions Patients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.

scholarly journals When to Resume Bariatric Surgery after COVID-19 Pandemic? – Results of Patients’ and Surgeons’ Survey.

2020 ◽  
Author(s):  
Aicja Dudek ◽  
Alicja Dudek ◽  
Michał Wysocki ◽  
Maciej Walędziak ◽  
Jacek Szeliga ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
World Health ◽  
Online Surveys ◽  
The World ◽  
Bariatric Patients ◽  
Group 2 ◽  
Health Organization ◽  
Current Body Mass Index ◽  
Group 1

Abstract BackgroundCOVID-19 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state.MethodsThe study was conducted in two groups: Group 1 – bariatric patients; Group 2 – bariatric surgeons. Two online surveys were distributed.Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p<0.001) and contact with COVID+/quarantined persons (p<0.001) had impact on the response to resumption of bariatric procedures.ConclusionsPatients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (02) ◽  
pp. 313-318
Author(s):  
MOHAMMAD ADNAN NAZEER ◽  
HASAAN IMTIAZ ◽  
HARUN MAJID DAR ◽  
Zulfiqar Ali ◽  
Asma Samreen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Controlled Trial ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Delayed Group ◽  
Group 2 ◽  
Group 1

Introduction: The role of laparoscopic cholecystectomy in treatment of acute cholecystitis is still controversial. Objective:The objective of this prospective randomized controlled trial was to evaluate the outcomes of early laparoscopic cholecystectomy foracute cholecystitis and to compare the results with delayed cholecystectomy. Setting: Sheikh Zayed Hospital, Lahore. Period: 1st Feb,2012 to 31st July 2012. Materials & Methods: 60 diagnosed patients of acute cholecystitis were randomly allocated to two groups,Group 1 underwent early laparoscopic cholecystectomy (Group 1, n = 30) and Group 2 to initial conservative treatment followed bydelayed laparoscopic cholecystectomy, 6 to 12 weeks later (Group 2 , n = 30). Results: The overall complication rate was 3.3% (01) inearly group and 16.7% (05) in the delayed group. There was no common bile duct injury in both groups. The complications includedwound infection and intraperitoneal collection. Conclusions: According to the results our study we concluded that early laparoscopiccholecystectomy can safely be carried out for acute cholecystitis as the complications for early laparoscopic cholecystectomy are lessas compared to delayed laparoscopic cholecystectomy. Early laparoscopic cholecystectomy has also an edge over delayed because ofsingle hospital stay.

Effect of Unilateral Accessory Navicular Bone on Radiologic Parameters of Foot

2020 ◽  
pp. 107110072096482
Author(s):  
Mustafa Kara ◽  
Serkan Bayram
Keyword(s):  
Navicular Bone ◽  
Level Of Evidence ◽  
First Metatarsal ◽  
Metatarsal Angle ◽  
Asymptomatic Patients ◽  
Accessory Navicular ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: This study aimed to compare the radiologic parameters of both feet in patients with unilateral accessory navicular bone (ANB) and evaluate the differences from one another. Methods: Forty-one patients with unilateral ANB volunteered to participate in this study from August 2019 to January 2020. Patient data, including age, sex, body mass index (BMI), type of ANB, and presence of symptoms were obtained. Group 1 comprised 23 patients with asymptomatic unilateral ANB, and group 2 comprised 18 patients with symptomatic unilateral ANB. Seven radiologic parameters were evaluated assessing hindfoot, midfoot, and forefoot alignment—calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap (NCO), talonavicular coverage angle (TNCA), anteroposterior talo–first metatarsal angle, and lateral talo–first metatarsal angle. Results: The mean age of patients was 40.1 years in group 1 and 42.6 years in group 2. Mean BMI was 25.2 in group 1 and 26.6 in group 2. No significant differences were noted in the radiologic parameters between the ANB and contralateral sides in all patients. The radiologic parameters of both feet in symptomatic and asymptomatic patients were not significantly different. No significant differences were noted between the affected sides of type 1 and 2 ANB and contralateral sides in terms of the radiologic parameters. BMI was significantly correlated with NCO and TNCA. Conclusion: This study demonstrated that the presence of an accessory navicular bone did not affect radiologic parameters of the foot. Radiologic parameters of both feet in symptomatic patients were not significantly different. Level of Evidence: Level III, diagnostic, comparative study.

scholarly journals Computed tomography-assisted morphological assessment of the components of the temporomandibular joint – a pilot study

New Medicine ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Maja Stańczyk ◽  
Ronald Lukashevich ◽  
Aleksandra Gorzkowska ◽  
Paulina Urbańska ◽  
Piotr Laskowski ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Temporomandibular Joint ◽  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Accurate Analysis ◽  
Asymptomatic Patients ◽  
Mandibular Fossa ◽  
Group 2 ◽  
Medical University ◽  
Group 1

Introduction. Temporomandibular joint (TMJ) disorders are a common diagnostic problem. No universal radiological parameter of the analysis was introduced. Aim. Comparison of values of selected radiological parameters between asymptomatic patients and those with the TMJ arthropathy. Material and methods. Retrospective analysis of CT scans of patients of the Department of Dental and Maxillofacial Radiology and the Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Medical University of Warsaw. Patients were divided into two groups: 1. without TMJ disorders, 2. with TMJ dysfunction symptoms. Following parameters of heads of mandible were analyzed bilaterally: shape, anteroposterior and lateromedial dimensions, the distance between lateral points of both heads (HL-HR), distance between a head and the mandibular fossa. The angle between the horizontal axis of the head of mandible and the line drawn by posterior points of heads of mandible was measured. Results. The most common type of the head of mandible in group 1 (40 patients; 13 women, 27 men) was convex (14 patients), in group 2 (16 patients; 14 women, 2 men) – plane (8 patients). Significant differences between groups were obtained for: GL-GP (group 1 – 120.35 mm, group 2 – 115.4 mm), dimensions of heads of mandible: lateromedial – 19.7 mm, 18.14 mm, anteroposterior – 8.03 mm, 7.04 mm for group 1 and 2, respectively. Conclusions. Computed tomography allowed for an accurate analysis of the TMJ components. Measurements of structures discussed in this work should be a part of the diagnosis of patients with TMJ dysfunction.

scholarly journals When to resume bariatric surgery after COVID-19 pandemic? – results of patients’ and surgeons’ survey.

2021 ◽  
Author(s):  
Alicja Dudek ◽  
Michał Wysocki ◽  
Maciej Walędziak ◽  
Jacek Szeliga ◽  
Monika Proczko-Stepaniak ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
World Health ◽  
Online Surveys ◽  
The World ◽  
Bariatric Patients ◽  
Group 2 ◽  
Health Organization ◽  
Current Body Mass Index ◽  
Group 1

Abstract BackgroundCoronavirus Disease 2019 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state.MethodsThe study was conducted in two groups: Group 1 – bariatric patients; Group 2 – bariatric surgeons. Two online surveys were distributed.ResultsA total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p<0.001) and contact with COVID+/quarantined persons (p<0.001) had impact on the response to resumption of bariatric procedures.ConclusionsPatients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.Trial registration: 1072.6120.103.2020

scholarly journals Evaluation of the True View PCD Video Laryngoscope for Oral Endotracheal Intubation

2020 ◽  
Vol 5 (2) ◽  
pp. 57-61
Author(s):  
Neha Agrawal ◽  
Alks Shah ◽  
Balraj Joshi ◽  
Pinal Vasani
Keyword(s):  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Demographic Data ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Lehane Grade ◽  
Group 2 ◽  
Difficulty Score ◽  
Group 1

Background: Truview PCD video laryngoscope is particularly planned to assist in locating the endotracheal tube in addition to observe the admission of the tube into the glottis. The present study was performed to assess the outlook of glottic opening and relief of intubation between the Truview PCD laryngoscope and Macintosh laryngoscope in patients undergoes general anaesthesia. Subjects and Methods: Ninety patients of ASA grade 1 and 2 aged 18-60 years, posted for elective surgery under general anaesthesia needing endotracheal intubation were arbitrarily allocated into group 1 (Truview PCD laryngoscope n=45) and group 2 (Macintosh laryngoscope n=45). The two groups were compared for demographic data, intubation difficulty score, Cormack-Lehane grade, time to intubate, number of intubation attempts and hemodynamic parameters. Conclusion: Truview PCD can be measured as an alternate intubation device, especially in difficult intubation conditions.

scholarly journals When to resume bariatric surgery after COVID-19 pandemic? – results of patients’ and surgeons’ survey.  

2020 ◽  
Author(s):  
Alicja Dudek ◽  
Michał Wysocki ◽  
Maciej Walędziak ◽  
Jacek Szeliga ◽  
Monika Proczko-Stepaniak ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
World Health ◽  
Online Surveys ◽  
The World ◽  
Bariatric Patients ◽  
Group 2 ◽  
Health Organization ◽  
Current Body Mass Index ◽  
Group 1

Abstract BackgroundCoronavirus Disease 2019 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state.MethodsThe study was conducted in two groups: Group 1 – bariatric patients; Group 2 – bariatric surgeons. Two online surveys were distributed.Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p<0.001) and contact with COVID+/quarantined persons (p<0.001) had impact on the response to resumption of bariatric procedures. ConclusionsPatients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel. Trial registration: 1072.6120.103.2020

MO748CORONARY ARTERY CALCIUM SCORE IN ASYMPTOMATIC PATIENTS RECEIVING CHRONIC HAEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jovana Kusic Milicevic ◽  
Radosav Vidakovic ◽  
Marija Andjelkovic Apostolovic ◽  
Branislav Apostolovic ◽  
Ana Ostojic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Serum Iron ◽  
Calcium Score ◽  
Early Years ◽  
Magnesium Concentration ◽  
Asymptomatic Patients ◽  
Group 3 ◽  
Group 2 ◽  
Cv Disease ◽  
Group 1

Abstract Background and Aims Vascular calcification has been reported to be an independent predictor of all-cause mortality and cardiovascular (CV) events in patients with end-stage renal disease. Even in previously asymptomatic patients, early years of haemodialysis (HD) are associated with high CV morbidity and mortality rates. Thus, it is important to precisely and timely identify individuals at risk of coronary artery disease (CAD) who would benefit from further CV treatment. Coronary artery calcium score (CACS) is an accurate tool for noninvasive assessment of CAD. This study aimed to evaluate CACS in asymptomatic HD patients in early years of treatment. Method This multicentric observational study included 60 patients receiving chronic HD for less than 4 years, with neither signs nor symptoms of CV disease. All patients underwent multislice computed tomography to identify coronary artery calcifications according to the standard procedure. CACS was calculated by the Agatston method individually for the left main, left circumflex, left anterior descending, and right coronary arteries and then summed to calculate the total CACS for each patient. Patients were distributed based on CACS: group 1 with CACS = 0, group 2 with CACS ranging from 1 to 400, and group 3 with CACS &gt; 400. Results Nine patients (89% men) had CACS = 0, 34 (47% men) had CACS 1-400, and 17 (76.5% men) had CACS &gt; 400 (χ2 = 7.467; p = 0.024). The mean age was 51±7, 61±12 and 64±8 years in groups 1, 2 and 3, respectively (p = 0.016). Patients in group 1 were significantly younger than patients in group 2 (p = 0.046) and group 3 (p = 0.012). The highest percentage of men was observed in group 1 (x2 = 7,668; p = 0.022). Other investigated demographic characteristics (dialysis vintage, body mass index, smoking history, family CV history, systolic and diastolic blood pressure), comorbidities (hypertension, diabetes, hyperparathyroidism, hyperlipidemia) and therapy (angiotensin converting enzyme inhibitors, angiotensin receptor blockers, statins, vitamin D, CaCO3, dialysate-magnesium concentration) did not differ significantly between the investigated groups. CACS showed statistically significant negative correlation with the serum iron (σ = - 0.351; p = 0.007), while other laboratory parameters (including calcium phosphate product) did not show statistically significant correlations. Conclusion Older age and low serum iron are associated with higher CACS in asymptomatic patients in the early years of HD. Therefore, these patients should be closely monitored for the early signs of CV disease.

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