Skip to main content
Erschienen in: Obesity Surgery 1/2021

11.09.2020 | Original Contributions

Variation in Small Bowel Length and Its Influence on the Outcomes of Sleeve Gastrectomy

Erschienen in: Obesity Surgery | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Small bowel length is drawing attention in the development of gastrointestinal bariatric/metabolic surgery, but the importance of the length of the small bowel in bariatric/metabolic is not clear. The present study was conducted to investigate variations in small bowel length and their clinical significance in patients undergoing laparoscopic sleeve gastrectomy (LSG).

Materials and Methods

Small bowel length was measured in 620 patients diagnosed with obesity who underwent LSG between March 2014 and August 2018. Prospectively obtained demographic and clinical data were investigated, focusing on the association between small bowel length and weight loss.

Results

Small bowel length varied widely among patients (mean 739.8 + 115.7 cm, range 380–1050 cm). Linear regression analysis revealed a significant association between small bowel length and body height, body weight, waist circumference, and serum levels of low-density lipoprotein cholesterol, hemoglobin, C-peptide, glycated hemoglobin (A1C), and gamma-glutamyl transferase (r-GT). Multivariate analysis confirmed that body height and serum A1C% levels independently predicted small bowel length in bariatric patients, strongly with body height (p < 0.001) but weakly with A1C%(p = 0.021). One-year follow-up rate was 75.3% (467/620), and small bowel length did not influence weight loss or the reduction of obesity related cardiovascular risk factors after LSG.

Conclusion

In this study, small bowel length varied widely among bariatric patients and was strongly associated with body height and weakly with serum A1C levels. Small bowel length has no significant role in weight loss or the resolution of cardiovascular risk factors after LSG.
Literatur
1.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
2.
Zurück zum Zitat Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.PubMedCrossRef
3.
Zurück zum Zitat Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.PubMedCrossRef Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.PubMedCrossRef
4.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.PubMedCrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.PubMedCrossRef
5.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: Primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.PubMedCrossRef Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: Primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.PubMedCrossRef
6.
Zurück zum Zitat Iaconelli A, Panunzi S, De Gaetano A, et al. Effects of biliopancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes Care. 2011;34:561–7.PubMedPubMedCentralCrossRef Iaconelli A, Panunzi S, De Gaetano A, et al. Effects of biliopancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes Care. 2011;34:561–7.PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Sanchez-Pernaute A, Herrera AR, Perez-Aguirre MEP, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20:1720–6.PubMedCrossRef Sanchez-Pernaute A, Herrera AR, Perez-Aguirre MEP, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20:1720–6.PubMedCrossRef
8.
Zurück zum Zitat Ahuja A, Tantia O, Gyyal G, et al. MGB-OAGB: effect of biliopancreatic limb length on nutritional deficiency, weight loss, and comorbidity resolution. Obes Surg. 2018;28:3439–45.PubMedCrossRef Ahuja A, Tantia O, Gyyal G, et al. MGB-OAGB: effect of biliopancreatic limb length on nutritional deficiency, weight loss, and comorbidity resolution. Obes Surg. 2018;28:3439–45.PubMedCrossRef
9.
Zurück zum Zitat Ghiassi S, Higa K, Chang S, et al. Conversion of standard Roux-en-Y gastric bypass to distal bypass for weight loss failure and metabolic syndrome: 3-year follow-up and evolution of technique to reduce nutritional complications. Surg Obes Relat Dis. 2018;14(5):554–61.PubMedCrossRef Ghiassi S, Higa K, Chang S, et al. Conversion of standard Roux-en-Y gastric bypass to distal bypass for weight loss failure and metabolic syndrome: 3-year follow-up and evolution of technique to reduce nutritional complications. Surg Obes Relat Dis. 2018;14(5):554–61.PubMedCrossRef
10.
Zurück zum Zitat Caruana TA, Monte SV, Jacobs DM, et al. Distal small bowel bypass for weight regain after gastric bypass: safety and efficacy threshold occurs at < 70% bypass. Surg Obes Relat Dis. 2015;11:1248–56.PubMedCrossRef Caruana TA, Monte SV, Jacobs DM, et al. Distal small bowel bypass for weight regain after gastric bypass: safety and efficacy threshold occurs at < 70% bypass. Surg Obes Relat Dis. 2015;11:1248–56.PubMedCrossRef
11.
Zurück zum Zitat Ohta M, Seki Y, Wong SK, et al. Bariatric/metabolic surgery in the Asia-Pacific region: APMBSS 2018 survey. Obes Surg. 2019;29:534–41.PubMedCrossRef Ohta M, Seki Y, Wong SK, et al. Bariatric/metabolic surgery in the Asia-Pacific region: APMBSS 2018 survey. Obes Surg. 2019;29:534–41.PubMedCrossRef
12.
Zurück zum Zitat Lee WJ, Chen CY, Chong K, et al. Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:683–90.PubMedCrossRef Lee WJ, Chen CY, Chong K, et al. Changes in postprandial gut hormones after metabolic surgery: a comparison of gastric bypass and sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:683–90.PubMedCrossRef
13.
Zurück zum Zitat Yousseif A, Emmanuel J, Karra E, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2014;24(2):241–52.PubMedCrossRef Yousseif A, Emmanuel J, Karra E, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2014;24(2):241–52.PubMedCrossRef
14.
Zurück zum Zitat Kasama K, Tagaya N, Kanehira E, et al. Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results. Obes Surg. 2009;19:1341–5.PubMedCrossRef Kasama K, Tagaya N, Kanehira E, et al. Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results. Obes Surg. 2009;19:1341–5.PubMedCrossRef
15.
Zurück zum Zitat De Paula AL, Stical AR, Macedo A, et al. Prospective randomized controlled trial comparing 2 varians of laparoscopic ileal interposition associated with sleeve gastrectomy for patients with type 2 diabetes with BMI 21-34 kg/m2. Surg Obes Relat Dis. 2010;6:296–305.PubMedCrossRef De Paula AL, Stical AR, Macedo A, et al. Prospective randomized controlled trial comparing 2 varians of laparoscopic ileal interposition associated with sleeve gastrectomy for patients with type 2 diabetes with BMI 21-34 kg/m2. Surg Obes Relat Dis. 2010;6:296–305.PubMedCrossRef
16.
Zurück zum Zitat Melissa J, Peppe A, Askoxilakis J, et al. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic disease: a promising operation. Obes Surg. 2012;22:1104–9.CrossRef Melissa J, Peppe A, Askoxilakis J, et al. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic disease: a promising operation. Obes Surg. 2012;22:1104–9.CrossRef
17.
Zurück zum Zitat Santoro S, Castro LC, Nelhote MCP, et al. Sleeve gastrectomy with transit bipartition: a potential intervention for metabolic syndrome and obesity. Ann Surg. 2012;256:104–10.PubMedCrossRef Santoro S, Castro LC, Nelhote MCP, et al. Sleeve gastrectomy with transit bipartition: a potential intervention for metabolic syndrome and obesity. Ann Surg. 2012;256:104–10.PubMedCrossRef
18.
Zurück zum Zitat Almo M, Sepulveda M, Gellona J, et al. Sleeve gastrectomy with jejunal bypass for the treatment of type 2 diabetes mellitus in patients with body mass index < 35 kg/m2: a cohort study. Obes Surg. 2012;22:1097–103.CrossRef Almo M, Sepulveda M, Gellona J, et al. Sleeve gastrectomy with jejunal bypass for the treatment of type 2 diabetes mellitus in patients with body mass index < 35 kg/m2: a cohort study. Obes Surg. 2012;22:1097–103.CrossRef
19.
Zurück zum Zitat Lee WJ, Lee KT, Kasama K, et al. Laparoscopic single-anastomosis duodenal–jejunal bypass with sleeve gastrectomy (SADJB-SG): short-term result and comparison with gastric bypass. Obes Surg. 2014;24:109–13.PubMedCrossRef Lee WJ, Lee KT, Kasama K, et al. Laparoscopic single-anastomosis duodenal–jejunal bypass with sleeve gastrectomy (SADJB-SG): short-term result and comparison with gastric bypass. Obes Surg. 2014;24:109–13.PubMedCrossRef
21.
Zurück zum Zitat Lee WJ, Chen JC, Yao WC, et al. Transumbilical 2-site laparoscopic Roux-en-Y gastric bypass: initial results of 100 cases and comparison with traditional laparoscopic technique. Surg Obes Relat Dis. 2012;8(2):208–13.PubMedCrossRef Lee WJ, Chen JC, Yao WC, et al. Transumbilical 2-site laparoscopic Roux-en-Y gastric bypass: initial results of 100 cases and comparison with traditional laparoscopic technique. Surg Obes Relat Dis. 2012;8(2):208–13.PubMedCrossRef
22.
Zurück zum Zitat Ser KH, Lee WJ, Lee YC, et al. Experience in laparoscopic sleeve gastrectomy for morbid obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endosc. 2010;16:2253–9.CrossRef Ser KH, Lee WJ, Lee YC, et al. Experience in laparoscopic sleeve gastrectomy for morbid obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endosc. 2010;16:2253–9.CrossRef
23.
Zurück zum Zitat Chiu CC, Lee WJ, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations. Obes Surg. 2006;16(7):913–8.PubMedCrossRef Chiu CC, Lee WJ, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations. Obes Surg. 2006;16(7):913–8.PubMedCrossRef
24.
Zurück zum Zitat Backman L, Hallberg D. Small intestine length. An intraoperative study in obesity. Acta Chir Scand Suppl. 1974;140:57–61. Backman L, Hallberg D. Small intestine length. An intraoperative study in obesity. Acta Chir Scand Suppl. 1974;140:57–61.
25.
Zurück zum Zitat Guzman IG, Fitch LL, Varro RL. Small bowel length in hyperlipidemia and massive obesity. Am J Clin Nutr. 1977;30:1006–8.PubMedCrossRef Guzman IG, Fitch LL, Varro RL. Small bowel length in hyperlipidemia and massive obesity. Am J Clin Nutr. 1977;30:1006–8.PubMedCrossRef
26.
Zurück zum Zitat Nordgren S, McPheeters G, Svaninger G, et al. Small bowel length in inflammatory bowel disease. Int J Color Dis. 1977;12:230–4.CrossRef Nordgren S, McPheeters G, Svaninger G, et al. Small bowel length in inflammatory bowel disease. Int J Color Dis. 1977;12:230–4.CrossRef
28.
Zurück zum Zitat Raines D, Arbour A, Thompson HW, et al. Variation in small bowel length: factor in achieving total enteroscopy? Dig Endosc. 2015;27(1):67–72.PubMedCrossRef Raines D, Arbour A, Thompson HW, et al. Variation in small bowel length: factor in achieving total enteroscopy? Dig Endosc. 2015;27(1):67–72.PubMedCrossRef
29.
Zurück zum Zitat Tacchino RM. Bowel length: measurement, predictors, and impact on bariatric and metabolic surgery. Surg Obes Relat Dis. 2015;11(2):328–34.PubMedCrossRef Tacchino RM. Bowel length: measurement, predictors, and impact on bariatric and metabolic surgery. Surg Obes Relat Dis. 2015;11(2):328–34.PubMedCrossRef
30.
Zurück zum Zitat Purandare A, Phalgune D, Shah S. Variability of length of small intestine in Indian population and its correlation with type 2 diabetes mellitus and obesity. Obes Surg. 2019;29:3149–53.PubMedCrossRef Purandare A, Phalgune D, Shah S. Variability of length of small intestine in Indian population and its correlation with type 2 diabetes mellitus and obesity. Obes Surg. 2019;29:3149–53.PubMedCrossRef
31.
Zurück zum Zitat Bekhelt M, Ibrahim MY, Tobar W, et al. Correlation between the total small bowel length and anthropometric measures in living humans: cross-sectional study. Obes Surg. 2020;30:681–6.CrossRef Bekhelt M, Ibrahim MY, Tobar W, et al. Correlation between the total small bowel length and anthropometric measures in living humans: cross-sectional study. Obes Surg. 2020;30:681–6.CrossRef
32.
Zurück zum Zitat Rubino F, Marescaux J. Effect of duodenal- jejunal exclusion in a nonobese animal model of type 2 diabetes: a new perspective for an old disease. Ann Surg. 2004;239:1–11.PubMedPubMedCentralCrossRef Rubino F, Marescaux J. Effect of duodenal- jejunal exclusion in a nonobese animal model of type 2 diabetes: a new perspective for an old disease. Ann Surg. 2004;239:1–11.PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Thaler JP, Cummings DE. Minireview: hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery. Endocrinology. 2009;150:2518–25.PubMedCrossRef Thaler JP, Cummings DE. Minireview: hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery. Endocrinology. 2009;150:2518–25.PubMedCrossRef
34.
Zurück zum Zitat Cefalu W, Rubino F, Cummings DE. Metabolic surgery for type 2 diabetes: changing the landscape of diabetes care. Diabetes Care. 2016;39:857–60.PubMedPubMedCentralCrossRef Cefalu W, Rubino F, Cummings DE. Metabolic surgery for type 2 diabetes: changing the landscape of diabetes care. Diabetes Care. 2016;39:857–60.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Sjostrom L et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.PubMedCrossRef Sjostrom L et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.PubMedCrossRef
36.
Zurück zum Zitat Chen Y, Corsino L, Shantavasinkul P, et al. Gastric bypass surgery leads to long-term remission or improvement of type 2 diabetes and significant decrease of microvascular and macrovascular complications. Ann Surg. 2016;263:1138–42.PubMedCrossRef Chen Y, Corsino L, Shantavasinkul P, et al. Gastric bypass surgery leads to long-term remission or improvement of type 2 diabetes and significant decrease of microvascular and macrovascular complications. Ann Surg. 2016;263:1138–42.PubMedCrossRef
37.
Zurück zum Zitat Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146:143–8.PubMedCrossRef Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146:143–8.PubMedCrossRef
38.
Zurück zum Zitat Inabnet WB, Qinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI < 50: a prospective randomized trial comparing short and long limb bypass. Obes Surg. 2005;15(1):51–7.PubMedCrossRef Inabnet WB, Qinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI < 50: a prospective randomized trial comparing short and long limb bypass. Obes Surg. 2005;15(1):51–7.PubMedCrossRef
39.
Zurück zum Zitat Homan J, Boerboom A, Aarts E, et al. A longer biliopancreatic limb in Roux-en-Y gastric bypass improves weight loss in the first year after surgery: results of a randomized controlled trial. Obes Surg. 2018;28(12):3744–55.PubMedCrossRef Homan J, Boerboom A, Aarts E, et al. A longer biliopancreatic limb in Roux-en-Y gastric bypass improves weight loss in the first year after surgery: results of a randomized controlled trial. Obes Surg. 2018;28(12):3744–55.PubMedCrossRef
40.
Zurück zum Zitat Boerboom A, Homan J, Aarts E, et al. A long biliopancreatic limb and short alimentary limb results in more weight loss in revisional RYGB surgery: outcomes of the randomized controlled trialandomized controlled trial. Surg Obes Relat Dis. 2019;15(1):60–9.PubMedCrossRef Boerboom A, Homan J, Aarts E, et al. A long biliopancreatic limb and short alimentary limb results in more weight loss in revisional RYGB surgery: outcomes of the randomized controlled trialandomized controlled trial. Surg Obes Relat Dis. 2019;15(1):60–9.PubMedCrossRef
41.
Zurück zum Zitat Miyachi T, Nagao M, Shikashi S, et al. Biliopancreatic limb plays an important role in metabolic improvement after duodenal-jejunal bypass in a rat model of diabetes. Surgery. 2016;159(5):1360–71.PubMedCrossRef Miyachi T, Nagao M, Shikashi S, et al. Biliopancreatic limb plays an important role in metabolic improvement after duodenal-jejunal bypass in a rat model of diabetes. Surgery. 2016;159(5):1360–71.PubMedCrossRef
42.
Zurück zum Zitat Nora M, Morals T, Almeida R, et al. Should Roux-en-Y gastric bypass biliopancreatic limb length be tailored to achieve improved diabetes outcomes? Medicine. 2017;96(48):e8859.PubMedPubMedCentralCrossRef Nora M, Morals T, Almeida R, et al. Should Roux-en-Y gastric bypass biliopancreatic limb length be tailored to achieve improved diabetes outcomes? Medicine. 2017;96(48):e8859.PubMedPubMedCentralCrossRef
43.
Zurück zum Zitat Murad Jr AJ, Cohen RV, de Godoy EP, et al. A prospective single-arm trial of modified long biliopancreatic and short alimentary limbs Roux-en-Y gastric bypass in type 2 diabetes patients with morbid obesity. Obes Surg. 2018;28(3):599–605.PubMedCrossRef Murad Jr AJ, Cohen RV, de Godoy EP, et al. A prospective single-arm trial of modified long biliopancreatic and short alimentary limbs Roux-en-Y gastric bypass in type 2 diabetes patients with morbid obesity. Obes Surg. 2018;28(3):599–605.PubMedCrossRef
44.
Zurück zum Zitat Almalki O, Lee WJ, Chong K, et al. Laparoscopic gastric bypass for the treatment of type 2 diabetes: a comparison of Roux-en-Y versus single anastomosis gastric bypass. Surg Obes Relat Dis. 2018;14(4):509–16.PubMedCrossRef Almalki O, Lee WJ, Chong K, et al. Laparoscopic gastric bypass for the treatment of type 2 diabetes: a comparison of Roux-en-Y versus single anastomosis gastric bypass. Surg Obes Relat Dis. 2018;14(4):509–16.PubMedCrossRef
45.
Zurück zum Zitat Molinaro A, Wahlstrom A, Marschall HU. Role of bile acids in metabolic control. Trends Endocrinol Metab. 2018;29(1):31–41.PubMedCrossRef Molinaro A, Wahlstrom A, Marschall HU. Role of bile acids in metabolic control. Trends Endocrinol Metab. 2018;29(1):31–41.PubMedCrossRef
46.
Zurück zum Zitat Mika A, Kaska L, Proczko-Stepaniak M, et al. Evidence that the length of bile loop determines serum bile acid concentration and glycemic control after bariatric surgery. Obes Surg. 2018;28(11):3405–14.PubMedCrossRef Mika A, Kaska L, Proczko-Stepaniak M, et al. Evidence that the length of bile loop determines serum bile acid concentration and glycemic control after bariatric surgery. Obes Surg. 2018;28(11):3405–14.PubMedCrossRef
47.
Zurück zum Zitat Ise I, Tanaka N, Imoto H, et al. Changes in enterohepatic circulation after duodenal-jejunal bypass and reabsorption of bile acids in the bilio-pancreatic limb. Obes Surg. 2019;29:1901–10.PubMedCrossRef Ise I, Tanaka N, Imoto H, et al. Changes in enterohepatic circulation after duodenal-jejunal bypass and reabsorption of bile acids in the bilio-pancreatic limb. Obes Surg. 2019;29:1901–10.PubMedCrossRef
48.
Zurück zum Zitat Shin RD, Goldberg MB, Shafran AS, et al. Revision of Roux-en-Y gastric bypass with limb distalization for inadequate weight loss or weight regain. Obes Surg. 2019;29(3):811–8.PubMedCrossRef Shin RD, Goldberg MB, Shafran AS, et al. Revision of Roux-en-Y gastric bypass with limb distalization for inadequate weight loss or weight regain. Obes Surg. 2019;29(3):811–8.PubMedCrossRef
49.
Zurück zum Zitat Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.PubMedCrossRef Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.PubMedCrossRef
50.
Zurück zum Zitat Chen JC, Shen CY, Lee WJ, et al. Protein deficiency after gastric bypass: the role of common limb length in revision surgery. Surg Obes Relat Dis. 2019;15(2):441–6.PubMedCrossRef Chen JC, Shen CY, Lee WJ, et al. Protein deficiency after gastric bypass: the role of common limb length in revision surgery. Surg Obes Relat Dis. 2019;15(2):441–6.PubMedCrossRef
51.
Zurück zum Zitat Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29:3062–72.PubMedCrossRef Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29:3062–72.PubMedCrossRef
Metadaten
Titel
Variation in Small Bowel Length and Its Influence on the Outcomes of Sleeve Gastrectomy
Publikationsdatum
11.09.2020
Erschienen in
Obesity Surgery / Ausgabe 1/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04958-7

Weitere Artikel der Ausgabe 1/2021

Obesity Surgery 1/2021 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.