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11.
Case reports are presented on three patients treated for morbid obesity by vertical gastroplasty. Prior to surgery the patients
had diabetes which required insulin, up to 200 units per day, or oral hypoglycaemics for its control. Six months after surgery
the diabetes had been resolved in all three patients, and they were no longer dependent on medication. Subjective reports
from the patients suggests that their quality of life improved significantly. 相似文献
12.
A prospective study of biochemical changes after vertical banded gastroplasty for morbid obesity, in 94 patients (10 males
and 84 females, ages ranging from 18 to 59 years) has been carried out. Liver function tests and electrolyte estimations were
performed preoperatively, during hospitalisation for surgery, at 6 weeks and at 6 months postoperatively, and demonstrated
no significant changes in liver function in these patients 6 months after surgery. The study concludes that there is no increase
in the risk of liver damage or electrolyte disturbance after vertical gastroplasty, but that there may be subtle hepatic changes
present as gall bladder disease developed in 18 patients postoperation (19%). 相似文献
13.
Aidonopoulos AP Papavramidis ST Zaraboukas TG Habib HW Pothoulakis IG 《Obesity surgery》1994,4(1):8-12
Morbidly obese patients constitute a high risk group for the development of gallbladder disease. In our series 70 consecutive
patients underwent vertical gastroplasty in an effort to manage morbid obesity. The mean age was 37 years (range 20-60), and
the mean excess body weight was 92 kg (range 52-265). Six patients (8.5%) had undergone cholecystectomy before bariatric surgery
because of symptomatic cholelithiasis. The remaining 64 patients underwent cholecystectomy at the time of vertical gastroplasty.
Ninety-seven percent of the removed gallbladders had gross or histologic abnormalities, including cholelithiasis 18.5% (13
patients), and cholesterolosis 31% (22 patients). Histologically, chronic cholecystitis was present in all patients with cholelithiasis
and cholesterolosis. Chronic cholecystitis alone was found in 27 patients (38.5%) and only two patients (3%) had normal findings.
The mean excess body weight of the patients with cholesterolosis (96 kg) was not significantly greater than that of patients
with cholelithiasis (89 kg) or chronic cholecystitis (88 kg). Our findings suggest that cholecystectomy should be performed
in all morbidly obese patients concomitant with vertical gastroplasty. 相似文献
14.
Background: Hybrid, combined or mixed bariatric surgery is the combination of a degree of ‘malabsorption’ (as achieved by the intestinal bypass) with a ‘rrestriction’
(as achieved by gastric bypass or gastroplasty), thereby simultaneously reducing the absorption of fats in the small bowel
and decreasing the intake of food. Methods: A modification of the bilio-pancreatic diversion (BPD) with a duodenal switch
procedure, vertical lineal gastrectomy and preservation of the pylorus, has been used in 23 patients. The antropyloric pump
and 4 cm of the duodenum are left intact to preserve physiologic gastric emptying and to prevent anastomotic ulcer. The use
of staplers and continuous running sutures reduces surgical risks and operative time. Results: One patient, converted from
a vertical gastroplasty, had an intrathoracic esophageal perforation and died of multisystemic organ failure, a mortality
rate of 4.5%. One patient had a partial dehiscence of the laparotomy wound. Three patients developed subcutaneous seromas.
Mean weight losses during the first 4 months were 13, 11, 6 and 5 kg, with a loss of 70% of excess weight in patients approaching
1 year. No patient needs treatment for diarrhea. No serious secondary side-effects have been detected. Conclusion: This operation
appears to result in very satisfactory weight loss, improved quality of life, and a low incidence of complications. 相似文献
15.
16.
Background: The authors studied the results of silicone ring vertical gastroplasty (SRVG) in patients aged 50 years and older.
Methods: The early and late postoperative results in 28 patients aged 50 years or older undergoing SRVG were reviewed retrospectively.
The results were compared to those of 370 patients younger than 50 years operated during the same period. Results: There was
no postoperative mortality among patients aged 50 years and older. There was a significantly higher incidence of pulmonary
embolus and wound infection among patients aged 50 years and older (p < 0.05). The weight loss did not differ significantly between the two studied age groups. Conclusion: SRVG may be performed
on patients aged 50 years or older with acceptable complication rate and favourable postoperative results. 相似文献
17.
Mason EE 《Obesity surgery》1996,6(3):218-223
BACKGROUND: Have surgeons in North America accepted operations for the treatment of severe obesity? This question was posed by organizers of the Ninth International Symposium on Obesity Surgery that met in Stockholm in September, 1995. Study design: In order to obtain opinions which might help to answer the question posed, a 1-page questionnaire was sent to 151 chairmen of academic departments of surgery in North America in December 1994 asking about the acceptance and use of surgical operations for the treatment of severe obesity. RESULTS: Answers, received from 112 or 74%, indicated that operative treatment should be used (74%), was effective (77%) and safe (71 %). However, only 65% of departments provided such operations. Operative treatment for obesity was available outside the department in 53%. The operations most frequently used were Roux-en-Y gastric bypass (RGB) and vertical banded gastroplasty (VBG). A single operation was offered by 44 departments and a choice of two or more operations in 30 departments. RGB and VBG were equally in use. Gastric banding was used as an alternative to VBG in six departments. Other operations were in use in six departments either alone (three) or as alternatives to RGB and VBG (three). CONCLUSIONS: It appears that surgical treatment of obesity is accepted and available in the majority of academic departments of surgery. 相似文献
18.
The success of vertical gastroplasty may be jeopardized by gastric leakage or ulceration due to failure of the technique.
Reports of band erosion and staple-line leakage have led us to seek technical improvements to reduce technical failures. We
describe a modification to the technique of band placement and a manoeuvre to aid the placement of staples when the TA90 staple
gun is used. 相似文献
19.
Downie JR 《Obesity surgery》1992,2(1):75-78
This paper is based on observations on a personal series of patients who presented with severe ulcerating esophagitis, unresponsive
to medical treatment following a vertical stapled gastroplasty. With one exception this was a late complication in an effective
weight loss procedure. The therapeutic modalities chosen to treat this problem depended on patient choice, as well as personal
experience with treating earlier cases. Unfortunately, I could find little guidance in the literature or from my colleagues
on how to treat this problem. Conversion to a Roux-Y gastric bypass seemed the most satisfactory solution to the problem,
relieving the symptoms and maintaining the weight loss. 相似文献
20.
Erosion of Marlex Mesh Collar after Vertical Banded Gastroplasty 总被引:1,自引:0,他引:1
Marlex mesh, as opposed to silastic ring, when used as a collar in the bariatric procedure of vertical banded gastroplasty,
has been reported rarely to erode into the gastric lumen. We report two cases of such an erosion, of which one ended as a
complete internalization of the collar into the stomach. In one of the patients we observed a wider than expected portion
of tissue that had been encircled by the collar, which might have caused a local inflammatory reaction leading to the later
erosion. 相似文献