Quality of life after laparoscopic sleeve gastrectomy: Pre-operative, 1-year and 5-year results.

Introduction: The negative impact of obesity on the quality of life (QoL) and its association with multiple comorbidities is unquestionable. The primary objective of this study was to compare the QoL of patients before, 1 year and 5 years after laparoscopic sleeve gastrectomy (LSG). Secondary objectives were to evaluate the resolution of obesity-related comorbidities and weight loss success. Materials and Methods: We included patients who underwent LSG for body mass index (BMI) ≥30 kg/m2 between August 2016 and April 2017 and completed the Moorehead-Ardelt QoL Questionnaire II (MA II). Statistical analysis was conducted using SPSS IBM Statistics for Windows version 21. Results: In total, 64 patients participated with a female majority (73.44%) and a mean age of 36.09 with an average BMI at 40.47. Percentage of excess BMI loss and excess weight loss (% EWL) at one and 5 years after surgery went from 90.18% to 85.05% and 72.17% to 67.09%, respectively. The total MA II score before LSG was - 0.39 ± 0.94. Postoperatively, it increased to 1.73 ± 0.60 at 1 year and 1.95 ± 0.67 at 5 years. The positive impact of LSG on QoL was more significant in patients presenting ≥30% of weight loss and in females. At 5 years, a significant improvement in many comorbidities was noted except for arterial hypertension, coxalgia, gastro-oesophageal reflux disease and lower extremities' varices. Conclusion: LSG maintains a long-term QoL improvement, a significant EWL and a resolution of the most common obesity-associated comorbidities such as diabetes, dyslipidaemia and symptoms related to sleep apnoea.

Surviving the storm: A 6-year journey with bowel perforations and aneurysms in vascular Ehlers-Danlos syndrome - A case report.

INTRODUCTION: Throughout the literature, many cases of vascular Ehlers-Danlos were reported with a variation of its clinical presentation. This disease may present in many forms and aspects and some even die before seeking medical care and getting the right diagnosis due to its hard effect on patients. CASE PRESENTATION: We report a case of a 25-year-old female patient with a history of multiple bowel perforations that were operated on urgently numerous times and received many courses of a large spectrum of antibiotics for various infections. CLINICAL DISCUSSION: Further investigations showed that the patient had multiple aneurysms due to her disease, a hepatic aneurysm, a paraspinal, and a severally symptomatic wrist aneurysm. The patient presented a de novo variant in the COL3A1 gene. A management plan was personalized, and a family genetic investigation was carried out. CONCLUSION: This article contains a full history of this patient including all the surgical, medical, and radiological interventions.

Surgical management of gallstone ileus after one anastomosis gastric bypass: A case report.

BACKGROUND: Gallstone ileus following one anastomosis gastric bypass (OAGB) is an exceptionally rare complication. The presented case report aims to highlight the unique occurrence of this condition and its surgical management. Understanding the clinical presentation, diagnostic challenges and successful surgical intervention in such cases is crucial for healthcare professionals involved in bariatric surgery. CASE SUMMARY: We present a case report of gallstone ileus following OAGB and discuss its diagnosis and surgical management. A 66-year-old female with a history of OAGB presented to the emergency room with symptoms of small bowel obstruction. Computed tomography scan revealed a gallstone impacted in the distal ileum, causing obstruction. The patient underwent a laparoscopically assisted enterolithotomy, during which the gallstone was extracted and the enterotomy was closed. The patient had an uneventful recovery and was discharged on postoperative day four. CONCLUSION: Gallstone ileus should be considered as a possible complication after OAGB, and prompt surgical intervention is usually required for its management. This case report contributes to the limited existing literature, providing insights into the management of this uncommon complication.

Acute gastric twist after laparoscopic sleeve gastrectomy: A case series.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure. Like any surgical intervention, LSG is not free from complications. One of the rarest complications is gastric sleeve stenosis, caused by either stricture or axial rotation of the stomach (twisted gastric tube). There is no consensus on the management of such a complication due to several underlying mechanisms and different timings of presentation. METHODS: Between July 1, 2021 and December 31, 2021, we encountered three cases of acute gastric twist following LSG, and all of them required surgical intervention. All data (imaging results, operative reports and videos, discharge summaries, etc.) were retrospectively collected and analyzed after obtaining patients' informed consent. RESULTS: We report three cases of acute gastric twist post-sleeve gastrectomy, diagnosed by different imaging modalities which showed localized distal gastric twist. All patients underwent exploratory laparoscopy which confirmed gastric sleeve twist. Gastropexy by fixation of the gastric tube to the transverse mesocolon was done in the first case which presented a localized partial distal twist, and a gastro-jejunal anastomosis proximal to the gastric twist was performed in the two other cases to bypass the obstruction. All of them had excellent postoperative results and a total symptomatic resolution. CONCLUSION: We considered gastric tube fixation to the transverse mesocolon as a feasible option when the twist is local and partial. We also presented a new surgical modality to treat local complete distal gastric twist by a single gastro-jejunal latero-lateral anastomosis proximal to the twist, which seems safe and effective. The best method to treat such a complication is to prevent it by giving special attention to the different technical aspects of LSG.