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Journal Watch: 05/10/12

Analysis of factors predictive of gastrointestinal tract leak in laparoscopic and open gastric bypass

An analysis of 226,452 patients who underwent either laparoscopic or open gastric bypass surgery between 2006 and 2008 reveals that laparoscopic surgery results in a significantly lower GI tract leak rate than open surgery; other risk factors include congestive heart failure, chronic renal failure, and patient age over 50 years. Race, hypertension, type 2 diabetes, or sleep apnea had no effect on leak rate. (Full text)

Perioperative outcomes of revisional laparoscopic gastric bypass after failed adjustable gastric banding and after vertical banded gastroplasty: experience with 107 cases and subgroup analysis

Revisional laparoscopic Roux-en-Y gastric bypass is a more effective operation after a failed gastric band than a failed sleeve gastrectomy, according to this study by researchers from Heilig Hart Ziekenhuis, Belgium. Major early complications occurred significantly more frequently after sleeve gastrectomy than after gastric band. (Full text)

Laparoscopic Roux-en-Y Vs. Mini-gastric Bypass for the Treatment of Morbid Obesity: a 10-Year Experience.

1,163 patients received a mini-gastric bypass, while 494 received a laparoscopic Roux-en-Y gastric bypass for this study by researchers from National Taiwan University, Taiwan. Surgical time was significantly longer for the Roux-en-Y patients, and the major complication rate was borderline higher. Mini-gastric bypass patients also had a higher excess weight loss after five years, leading the researchers to conclude that mini-gastric bypass should be regarded as a simpler and safer alternative to Roux-en-Y. (Full text)

Secondary Hyperparathyroidism, Vitamin D Sufficiency, and Serum Calcium 5 Years After Gastric Bypass and Duodenal Switch.

Researchers investigated the prevalence of secondary hyperparathyroidism five years after gastric bypass and duodenal switch, finding a high prevalence of the condition five years after surgery. Secondary hyperparathyroidism was inversely associated with serum ionised calcium, but not with vitamin D, implying that the vitamin supplementation used was insufficient to compensate for the impaired calcium absorption after surgery. (Full text)

Psychiatric Predictors of Surgery Non-completion Following Suitability Assessment for Bariatric Surgery.

What pre-surgical psychiatric factors can predict which patients will end up eventually undergoing surgery? This study from the University of Toronto finds that a history of Axis I psychiatric disorders, anxiety disorders, substance abuse or dependence disorders, and post-traumatic stress disorders make it significantly more likely that the patient will not complete surgery. The researchers conclude that additional psychosocial support may help improve patient completion of the pre-surgery assessment phase. (Full text)