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71 results on '"Biliopancreatic diversion"'

22. Does Bariatric Surgery Improve Faecal Incontinence? A Systematic Review and Meta-analysis

Author

Don Wilson, Fardowsa Mohamed, Megna Jeram, Melanie Lauti, Andrew D. MacCormick, and Christin Coomarasamy

Subjects
Adult, medicine.medical_specialty, Roux-en-Y gastric bypass, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Original Contributions, Pelvic floor disorder, Urinary incontinence, Gastric Bypass, law.invention, 03 medical and health sciences, 0302 clinical medicine, Duodenal switch, Randomized controlled trial, Quality of life, law, Gastrectomy, Medicine, Humans, Obesity, Depression (differential diagnoses), Bariatric surgery, Nutrition and Dietetics, business.industry, Faecal incontinence, medicine.disease, Surgery, Pelvic organ prolapse, Obesity, Morbid, Gastrointestinal health, 030220 oncology & carcinogenesis, Meta-analysis, Quality of Life, 030211 gastroenterology & hepatology, Observational study, Female, medicine.symptom, business, Biliopancreatic diversion, Fecal Incontinence
Abstract

Introduction Obesity increases the risk of pelvic floor disorders in individuals with obesity, including faecal incontinence. Faecal incontinence (FI) is a condition with important clinical and psychosocial consequences. Though it is associated with obesity, the effect of bariatric surgery on the prevalence and severity of FI is not well reported. Objective To assess the effect of bariatric surgery on the prevalence and severity of FI in adult patients with obesity. Methods This systematic review was conducted in accordance with the PRISMA statement. Two independent reviewers performed a literature search in MEDLINE, PubMed, Cochrane and Embase from 1 January 1980 to 12 January 2019. We included published English-language randomized control trials and observational studies assessing pre- and post-bariatric surgery prevalence or severity of FI. Random-effects models with DerSimonian and Laird’s variance estimator were used for meta-analysis. Results Thirteen studies were included, eight assessing prevalence (678 patients) and 11 assessing severity of FI (992 patients). There was no significant difference in prevalence post-operatively overall, though it trended towards a reduction [pooled OR=0.55; =0.075]. There was a significant reduction of FI prevalence in women post-bariatric surgery [95% CI 0.22 to 0.94, p=0.034]. There was a statistically significant reduction in FI prevalence following Roux-en-Y gastric bypass and one anastomosis gastric bypass [0.46, 95% CI 0.26 to 0.81; p=0.007]. There was no significant reduction of incontinence episodes post-operatively [pooled mean difference =−0.17, 95% CI −0.90 to 0.56; p=0.65]. Quality of life (QOL) was not significantly improved post-bariatric surgery [mean differences for the following facets of QOL: behaviour −0.35, 95% CI −0.94 to 0.24; depression 0.04, 95% CI −0.12 to 0.2; lifestyle −0.33, 95% CI −0.98 to 0.33; p values of 0.25, 0.61 and 0.33, respectively]. Discussion There was a significant reduction in FI prevalence in women and those who underwent Roux-en-Y or one anastomosis gastric bypass. Our results for FI prevalence overall, FI severity and impact on quality of life were not statistically significant. Larger studies are needed in this under-researched area to determine the true effect of bariatric surgery on FI. Graphical abstract

Published
2021

50. Changes in Serum Fatty Acid Levels During the First Year After Bariatric Surgery

Author

Chenchen Lin, Olav M. Kvalheim, Villy Våge, and Svein A. Mjøs

Subjects
Adult, Male, medicine.medical_specialty, Cardiovascular health, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Original Contributions, 030209 endocrinology & metabolism, Ratio of eicosapentaenoic acid (EPA) to arachidonic acid (AA), Biliopancratic diversion with a duodenal switch (BPDDS), Laparoscopic sleeve gastrectomy (LSG), 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Weight loss, Gastrectomy, Weight Loss, Medicine, Humans, 030212 general & internal medicine, Postoperative Period, Biliopancreatic Diversion, chemistry.chemical_classification, Bariatric surgery, Nutrition and Dietetics, Arachidonic Acid, business.industry, Fatty acid, Eicosapentaenoic acid, Duodenal switch, Surgery, Obesity, Morbid, Treatment Outcome, chemistry, Eicosapentaenoic Acid, Serum fatty acid levels, Arachidonic acid, Female, Laparoscopy, medicine.symptom, business
Abstract

Background: We have assessed the effects of laparoscopic sleeve gastrectomy (LSG) and biliopancratic diversion with a duodenal switch (BPDDS) on fatty acid (FA) levels in serum. In particular, we examine the impact of surgery on the ratio of the FAs eicosapentaenoic acid (EPA) to arachidonic acid (AA) which impacts, e.g., cardiovascular health. Our hypothesis is that LSG and BPDDS influence the FA levels but that BPDDS may have a more persistent impact since BPDSS superimposes intestinal malabsorption on gastric restriction. Methods: Serum samples after overnight fasting were collected 3 months and 1 day before surgery and 3 days, 3 months, and 12 months after surgery from 10 BPDDS patients and 23 LSG patients. The levels of 16 FAs were quantified by gas chromatography. Preoperative and postoperative concentrations of EPA and AA and the ratio of EPA to AA were compared by Wilcoxon signed-rank test corrected for multiple testing using false discovery rate. Results: The ratio of EPA/AA at each of the three postoperative sampling points was lower than at the two preoperative sampling points for BPDDS with p&thinsp

Published
2015

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