RESUMO
BACKGROUND: Less invasive endoscopic bariatric procedures are under development for the management of recurrence of obesity. The purpose of the current manuscript was to evaluate the safety of the endoscopic revisional gastroplasty (ERG) for patients with recurrence of weight gain following different bariatric procedures. MATERIALS AND METHODS: This is a retrospective single-center study over 22 patients using the ERG between January 2020 to July 2022 at Bouchard Private Hospital (Marseille, France). The demographic data, past surgical history, obesity complications, time interval between the surgical and endoscopic procedures, and intra and postoperative parameters and outcomes were analyzed. RESULTS: A total of 22 patients underwent ERG: 19 female (86.4%) with a mean age of 34.2 years and a mean BMI of 32.9 kg/m2 (± 3.4). Average time between the revisional bariatric surgery and ERG was 14.4 months (range 5-36). There were 14 cases of LSG (77.8%), 9 cases of RYGBP (19.4%), and 3 cases with previous gastric band. All procedures were completed by endoscopy with no complication and a mean length of hospital stay of 1.1 days (± 0.9). The weight loss results at 1-year follow-up were available for 17 of the 22 patients: two patients were lost to follow-up (4%) and 3 patients had less than a 1-year follow-up from the ERG. The mean BMI, 1 year after ERG, was 28.7 kg/m2 (± 7.4); the mean BMI loss and %EWL were, respectively, 4.2 kg/m2 (± 4.7) and 53.1% (± 17). CONCLUSION: Endoscopic revisional gastroplasty represents a safe minimal invasive approach that can be considered an effective and well-tolerated procedure for patients with previous bariatric surgery.
Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Gastroplastia , Laparoscopia , Obesidade Mórbida , Humanos , Feminino , Adulto , Gastroplastia/efeitos adversos , Gastroplastia/métodos , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Laparoscopia/métodos , Reoperação , Obesidade/cirurgia , Endoscópios , Resultado do TratamentoRESUMO
BACKGROUND: Hepatolithiasis (HL) is a rare disease in Western countries. The aim of our study was to investigate a possible relation between the development of right HL and abnormalities of the hepatic duct confluence. MATERIAL AND METHODS: Fourteen patients who presented with localized right-sided HL were included in this study. The anatomy of hepatic duct confluence in this group of patients was analyzed and compared with the anatomy of hepatic duct confluence in the general population. RESULTS: The Presence of a shift of 1 of the 2 sectorial right ducts was significantly associated with right-sided HL (P = .003). CONCLUSIONS: The shift of a sectorial right duct must be considered as one of the anatomic causes of HL. This finding must be considered when surgical treatment of HL is planned.