Asunto(s)
Prestación Integrada de Atención de Salud , Enfermedad Hepática en Estado Terminal/cirugía , Trasplante de Hígado , Donantes de Tejidos/provisión & distribución , Obtención de Tejidos y Órganos , Adulto , Anciano , Prestación Integrada de Atención de Salud/economía , Prestación Integrada de Atención de Salud/organización & administración , Enfermedad Hepática en Estado Terminal/diagnóstico , Enfermedad Hepática en Estado Terminal/economía , Enfermedad Hepática en Estado Terminal/epidemiología , Femenino , Costos de la Atención en Salud , Humanos , Cooperación Internacional , Kuwait/epidemiología , Trasplante de Hígado/economía , Donadores Vivos/provisión & distribución , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Factores de Tiempo , Obtención de Tejidos y Órganos/economía , Obtención de Tejidos y Órganos/organización & administraciónRESUMEN
INTRODUCTION: Failure of sleeve gastrectomy poses a potential challenge for surgeons as variable options exist for revision. One anastomosis gastric bypass (OAGB) is a potential revisional option, and in this study, we sought to determine the safety and efficacy of OAGB post sleeve gastrectomy. METHOD: Prospective study on our initial experience with a consecutive group of patients who underwent OAGB as a revisional surgery for sleeve gastrectomy in the period between January 2015 and December 2018 was carried out. Morbidity and mortality data were recorded as well as the effect on comorbidities and weight loss. RESULTS: A total of 56 patients underwent OAGB as a revision of sleeve gastrectomy. The average weight prior to OAGB was 112 ± 24.6 kg. The minimum weight they have reached after is 85 ± 21.3 kg after a duration of 19 ± 9.2 months. Percentage of total weight loss (TWL%) at 1, 3, 6, and 12 months postoperatively was found to be 7.6%, 9.8%, 14.1%, and 28.8%, respectively. TWL% on the last day of follow-up was 24%. Two patients had marginal ulcers, in which one had a perforation. CONCLUSION: OAGB is safe and effective for weight regain post sleeve gastrectomy.
Asunto(s)
Derivación Gástrica , Obesidad Mórbida , Gastrectomía , Derivación Gástrica/efectos adversos , Humanos , Obesidad Mórbida/cirugía , Estudios Prospectivos , Reoperación , Estudios RetrospectivosRESUMEN
INTRODUCTION: The use of laparoscopic management as a first choice for the treatment of duodenal perforation is gaining ground but is not routine in many centers. In this report, we aim to report our experience with laparoscopy as the first approach for the repair of duodenal perforation. MATERIALS AND METHODS: This is a retrospective review of patients during our initial experience with the use of laparoscopy for the treatment of duodenal perforation between 2009 and 2013. RESULTS: A total of 100 patients underwent management of duodenal perforation. Laparoscopy was attempted initially in 76 patients (76%) and completed in 64 patients (64%). The length of hospital stay was shorter in the laparoscopic group (mean 2.6) than in the open group (mean 3.1) (p = 0.008). Complications developed in 14 patients (20%). There was a tendency towards fewer admissions to intensive care, less acute kidney injuries, and less acute respiratory distress syndrome in the laparoscopic group. In patients who underwent laparoscopic surgery, the chances of uneventful recovery were 4.3 times higher than in those patients who underwent open surgery (95% CI 1.3-13.5, p = 0.014). CONCLUSIONS: Laparoscopy in the treatment of perforated duodenal ulcer is safe and can be utilized as a routine approach for the treatment of this pathology.
