RESUMEN
BACKGROUND: The diagnosis of gastric lesions, such as the Ectopic Gastric Pancreas (GEP), has become more frequent after the increase in bariatric surgeries. The most frequently used surgical options are: Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB). The scientific papers about GEP in Bariatric Surgery consisted of intraoperative findings, approach the lesion with gastrectomy and the need to change the initial surgical strategy of the Sleeve for others techniques which allow extended gastric resections. PRESENTATION OF CASE: This is a report on a 21-year-old female patient with class 3 obesity whose preoperative evaluation showed two lesions suggestive of GEP. Simultaneous surgical video-laparoscopic treatment of lesions associated with SG aided by intraoperative Upper Endoscopy (UE) was performed with no perioperative complications. CONCLUSION: It is possible to associate the treatment of rare gastric lesions with traditional surgery techniques for obesity.
RESUMEN
PURPOSE: Obesity is commonly associated with poor sleep, excessive daytime sleepiness (EDS) and depressive mood but the impact of bariatric surgery on these conditions is incompletely understood. This study aimed to investigate the course of EDS and sleep quality in bariatric surgery patients in relation with changes in body weight and depressive symptoms. METHODS: In patients consecutively submitted to bariatric surgery, baseline and postoperative sleep quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS), risk for OSA by the Berlin Questionnaire (BQ), and depressive symptoms by the Beck Depression Inventory-Short Form (BDI). Comorbidities were assessed by interview and chart review. RESULTS: Sixty patients (M/F = 9/51) with a mean (±SD) age of 34.7 ± 9.2 years and body mass index (BMI) of 46.04 ± 7.52 kg/m2 were studied. Bariatric surgery improved PSQI score (6.4 ± 3.8 versus 4.1 ± 2.8; p < 0.001), ESS score (8.1 ± 4.7 versus 6.0 ± 3.3; p < 0.001), BDI score (9.8 ± 7.0 versus 4.7 ± 4.6; p = 0.001), and risk for OSA (68.3 versus 5%). Twelve of the 18 subjects with baseline EDS (ESS ≥ 10) developed normal ESS score after surgery. In these subjects, significant postoperative improvement in depressive symptoms score was observed (12.0 ± 9.0 versus 5.5 ± 5.0; p = 0.041), in contrast to the remaining six cases with persistent EDS, who showed no significant change in these symptoms (5.5 ± 5.0 versus 3.2 ± 3.1; p = 0.416). CONCLUSION: Bariatric surgery has a beneficial effect on sleep quality and EDS. Postoperative improvement in EDS can be related to a reduction in depressive symptoms.