[Changes in quality of life in patients undergoing bariatric surgery following 24-months: comparison between gastric bypass and tubular vertical gastrectomy]. / Evolución de la calidad de vida a los 24 meses de seguimiento en pacientes sometidos a cirugía bariátrica: comparación entre el bypass gástrico y la gastrectomía vertical tubular.

BACKGROUND: Bariatric surgery has become the procedure of choice to deal with morbid and super-morbid obesity, with the greatest chance of success. The objectives of this study were: a) to analyse the evolution of the percentage of excess BMI lost (PEBMIL) and quality of life in the medium and long term after bariatric surgery; b) to evaluate the differences in PEBMIL and quality of life according to the surgical technique performed; and c) examine the relationship between PEBMIL and quality of life. METHODS: One hundred and ninety-one subjects participated in the present study, undergoing bariatric surgery with follow-up at 12 and 24 months after surgery. The SF-36 and OP-53 questionnaires were administered to assess the quality of life after surgery. RESULTS: There was a statistically significant reduction in the percentage of excess BMI lost at 12 and 24 months; and a significant improvement in quality of life at 12 months, which remained stable at 24 months for most variables. Taking into account the surgical technique, those undergoing gastric bypass surgery show a greater loss of PEBMIL at 12 and 24 months, and significant improvement at one year of evaluation in most of the dimensions that measure quality of life with respect to the tubular vertical gastrectomy technique. CONCLUSION: Bariatric surgery is effective in reducing the excess of BMI lost and significantly improving the quality of life of morbidly obese patients in the long term. Key words. Bariatric surgery. Quality of life. Morbid obesity.

[Gastric collision tumor with osseous metaplasia]. / Tumor de colisión gástrico con metaplasia osea.

Neuroendocrine cells are frequently found in gastric tumours, although they rarely make up more than one third of the total number of tumour cells. When juxtapositioning of the two kinds of tumour cells occurs a "collision tumour" is formed. These have been described to occur with varying frequency throughout the digestive tract. They are uncommon in the stomach. We describe a case, of a gastric collision tumour in which an adenocarcinoma coexisted with a carcinoide tumour and there were zones of bony metaplasia in the transition area between the two tumors. Positive CEA, VIP, beta-HCG and TSH on inmunohistochemical analysis was found.

[Ectopic pancreas]. / Páncreas ectópico.

We describe ten cases of ectopic pancreas operated on in the Hospital General Universitario, Alicante, between 1970 and 1994. Average age of patients was 47.7 (range 3-75); five men and five women. In four cases there was associated digestive tract bleeding, three had chronic gastroduodenal ulcers, two pancreaticobiliary disease, and one suprarenal abnormalities. In four cases the ectopic gland was found in the gastric antrum; in four cases in the duodenum and in the remaining two cases in the first jejunal loop. Average diameter was 2.3 cm (range 0.6-6). In six cases complete pancreas tissue was found, in three an exocrine pancreas and in one a purely endocrine pancreas. In two patients the presence of the choristoma and the clinical findings due to erosion of the subjacent mucosa may be related. In one case the finding of cholelithiasis, intradiverticular papilla, and periampullar ectopia together with clinical features of recurrent pancreatitis may also be linked. In the remaining seven cases no relationship was found between the ectopic pancreas and the clinical features. Our series suggest that simple resection is best to avoid complications.

[Granular cell tumor of the bile duct: an infrequent location]. / Tumor de células granulosas en la vía biliar: una localización poco frecuente.

We report a case of granular cell tumor of the cystic duct. We have found only 47 such tumors of the biliary tract reported in the literature. Main symptoms at presentation are abdominal pain or obstructive jaundice. The clinical diagnosis is often difficult and the differential diagnosis is established with other more frequent conditions, including malignant neoplasms. Surgical excision is curative.