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Zerrweck C.,The Obesity Clinic at Hospital General Tlahuac | Rodriguez J.G.,The Obesity Clinic at Star Medica Hospital | Aramburo E.,The Obesity Clinic at Star Medica Hospital | Vizcarra R.,The Obesity Clinic at Star Medica Hospital | And 4 more authors.
Obesity Surgery | Year: 2016

Background: The laparoscopic gastric plication (LGP) is a relative new bariatric procedure that has gained popularity over the last few years, but no real consensus exists and the evidence is unclear, especially in its real efficacy, safety, and durability. Methods: Retrospective study analyzing the records patients submitted to LGP between 2009 and 2010. The primary objective was to describe the characteristics and outcomes of patients submitted to revisional surgery. Baseline data and evolution were obtained and analyzed. Surgical analysis included revision cause, perioperative outcome, type of surgery, complications, and weight loss after 18 months. A comparison between gastric bypass and sleeve gastrectomy was performed. Results: One hundred LGP were performed. After a mean time of 13.5 months, 42 patients presented an overall excess weight loss (EWL) <50 % and 38 had severe symptoms. Thirty patients accepted revisional surgery with BMI before conversion of 38.6 ± 4.2 kg/m2. There were 17 laparoscopic sleeve gastrectomy (LSG) and 13 laparoscopic gastric bypass (LGBP) with comparable preoperative characteristics. The LSG group had lower pneumoperitoneum time and less hospital stay. At 18 months, the LGBP group had lower BMI (24.1 ± 1.1 vs. 25.8 ± 1.3 kg/m2 for the LSG; p = 0.006) and higher %EWL (75.7 ± 16.1 vs. 61.4 ± 14.5 % for the LSG; p = 0.008). Conclusion: In our series, LGP presented a high failure rate and an increased number of symptomatic patients. Revisional surgery proved to be safe and effective. Revision to LSG was faster and had less hospital stay. Revision to LGBP showed better %EWL at 18 months. © 2016 Springer Science+Business Media New York


PubMed | The Obesity Clinic at Star Medica Hospital and The Obesity Clinic at Hospital General Tlahuac
Type: Journal Article | Journal: Obesity surgery | Year: 2016

The laparoscopic gastric plication (LGP) is a relative new bariatric procedure that has gained popularity over the last few years, but no real consensus exists and the evidence is unclear, especially in its real efficacy, safety, and durability.Retrospective study analyzing the records patients submitted to LGP between 2009 and 2010. The primary objective was to describe the characteristics and outcomes of patients submitted to revisional surgery. Baseline data and evolution were obtained and analyzed. Surgical analysis included revision cause, perioperative outcome, type of surgery, complications, and weight loss after 18months. A comparison between gastric bypass and sleeve gastrectomy was performed.One hundred LGP were performed. After a mean time of 13.5months, 42 patients presented an overall excess weight loss (EWL) <50% and 38 had severe symptoms. Thirty patients accepted revisional surgery with BMI before conversion of 38.64.2kg/mIn our series, LGP presented a high failure rate and an increased number of symptomatic patients. Revisional surgery proved to be safe and effective. Revision to LSG was faster and had less hospital stay. Revision to LGBP showed better %EWL at 18months.


Zerrweck C.,The Obesity Clinic at Hospital General Tlahuac | Zurita L.,The Obesity Clinic At Hospital General Dr Ruben Lenero | Alvarez G.,The Obesity Clinic at Hospital General Tlahuac | Maydon H.G.,The Obesity Clinic at Hospital General Tlahuac | And 4 more authors.
Obesity Surgery | Year: 2015

Background: Alterations in taste/smell after bariatric surgery have been observed, but few data is available. Some authors documented these changes and their role on weight loss but there is no evidence after laparoscopic sleeve gastrectomy (LSG). Methods: Cohort study with patients submitted to laparoscopic gastric bypass (LGBP) and LSG that were asked to participate in a validated survey. The primary objective was to determinate the differences between procedures for taste and smell changes; a demographic and anthropometric analysis were also performed. Secondarily, the relation between food aversion and weight loss was also obtained. Results: Final analysis was based on 154 patients (104 LGBP and 50 LSG). The overall mean time between surgery and questionnaire was 10 ± 6.7 months. Most of the patients (87.6 %) experienced some taste/smell change. There were no differences between procedures for any change, taste or smell change. More patients submitted to LGBP referred that food smelled different (51.9 vs 34 % for the LSG group; p = 0.040). Higher %EWL was observed for patients presenting food aversion (73.3 ± 19.7 vs 65.8 ± 19.4 % for those without aversion; p = 0.046). Based on type of surgery, the LGBP group had the same trend (%EWL of 78.2 ± 17.3 vs 70.4 ± 18.6 % for those without aversion; p = 0.044). Conclusion: The majority of patients presented taste and olfactory changes soon after surgery independently of type of procedure. Patients submitted to LGBP referred more often a different smell in food. Higher %EWL was observed in patients presenting any food aversion, especially in the LGBP group. © 2015 Springer Science+Business Media New York


PubMed | The Obesity Clinic at Hospital General Tlahuac and The Obesity Clinic At Hospital General Dr Ruben Lenero
Type: Journal Article | Journal: Obesity surgery | Year: 2016

Alterations in taste/smell after bariatric surgery have been observed, but few data is available. Some authors documented these changes and their role on weight loss but there is no evidence after laparoscopic sleeve gastrectomy (LSG).Cohort study with patients submitted to laparoscopic gastric bypass (LGBP) and LSG that were asked to participate in a validated survey. The primary objective was to determinate the differences between procedures for taste and smell changes; a demographic and anthropometric analysis were also performed. Secondarily, the relation between food aversion and weight loss was also obtained.Final analysis was based on 154 patients (104 LGBP and 50 LSG). The overall mean time between surgery and questionnaire was 106.7months. Most of the patients (87.6%) experienced some taste/smell change. There were no differences between procedures for any change, taste or smell change. More patients submitted to LGBP referred that food smelled different (51.9 vs 34% for the LSG group; p=0.040). Higher %EWL was observed for patients presenting food aversion (73.319.7 vs 65.819.4% for those without aversion; p=0.046). Based on type of surgery, the LGBP group had the same trend (%EWL of 78.217.3 vs 70.418.6% for those without aversion; p=0.044).The majority of patients presented taste and olfactory changes soon after surgery independently of type of procedure. Patients submitted to LGBP referred more often a different smell in food. Higher %EWL was observed in patients presenting any food aversion, especially in the LGBP group.


Pineda O.,The Obesity Clinic at Hospital General Tlahuac | Maydon H.G.,The Obesity Clinic at Hospital General Tlahuac | Amado M.,The Obesity Clinic at Hospital General Tlahuac | Sepulveda E.M.,The Obesity Clinic at Hospital General Tlahuac | And 3 more authors.
Obesity Surgery | Year: 2016

Introduction: Bariatric surgery is the most effective therapy for weight loss in patients with morbid obesity. One of the most common long-term complications includes cholelithiasis. There is not a clear consensus in how to treat an asymptomatic gallbladder disease before and after bariatric surgery. Methods: Prospective study with every patient submitted to bariatric surgery from 2012 to 2014. The gallbladder status was assessed with an ultrasound before and after surgery (12 months), and a conservative management was conducted for patients with asymptomatic disease (preoperative and de novo); the need for delayed cholecystectomy was reported. Secondarily, an analysis of weight loss (%EWL) and gallbladder status was performed. Results: Two-hundred and two bariatric surgeries were performed. The global incidence of preoperative gallbladder disease was 34.3 %, with 14.2 % presenting sludge, 20.1 % asymptomatic gallstones, and 2.3 % symptomatic gallstones. The final analysis was based on 146 patients; female sex comprised 81.1 % of cases with a mean age of 38.5 years. After 12 months, de novo gallbladder disease was observed in 21.2 %. The overall rate of cholecystectomy because of symptomatic disease after 12 months was 3.4 % (2 % developed acute cholecystitis). There were no differences in %EWL between patients with de novo gallbladder disease and those without. Conclusion: Conservative management of asymptomatic gallbladder disease in candidates to bariatric surgery is safe and can be offered in every case, based on the low percentage of patients requiring further cholecystectomy after 12 months. Also, a conservative management can be offered to patients developing de novo sludge/cholelithiasis without related symptoms. © 2016 Springer Science+Business Media New York


PubMed | The Obesity Clinic at Hospital General Tlahuac
Type: | Journal: Obesity surgery | Year: 2016

Bariatric surgery is the most effective therapy for weight loss in patients with morbid obesity. One of the most common long-term complications includes cholelithiasis. There is not a clear consensus in how to treat an asymptomatic gallbladder disease before and after bariatric surgery.Prospective study with every patient submitted to bariatric surgery from 2012 to 2014. The gallbladder status was assessed with an ultrasound before and after surgery (12months), and a conservative management was conducted for patients with asymptomatic disease (preoperative and de novo); the need for delayed cholecystectomy was reported. Secondarily, an analysis of weight loss (%EWL) and gallbladder status was performed.Two-hundred and two bariatric surgeries were performed. The global incidence of preoperative gallbladder disease was 34.3%, with 14.2% presenting sludge, 20.1% asymptomatic gallstones, and 2.3% symptomatic gallstones. The final analysis was based on 146 patients; female sex comprised 81.1% of cases with a mean age of 38.5years. After 12months, de novo gallbladder disease was observed in 21.2%. The overall rate of cholecystectomy because of symptomatic disease after 12months was 3.4% (2% developed acute cholecystitis). There were no differences in %EWL between patients with de novo gallbladder disease and those without.Conservative management of asymptomatic gallbladder disease in candidates to bariatric surgery is safe and can be offered in every case, based on the low percentage of patients requiring further cholecystectomy after 12months. Also, a conservative management can be offered to patients developing de novo sludge/cholelithiasis without related symptoms.

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