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Bariatric Surgery

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Internal hernia after one anastomosis gastric bypass (OAGB): lessons learned from a retrospective series of 3368 consecutive patients undergoing OAGB with a biliopancreatic limb of 150 cm.
Petrucciani N, Martini F, Kassir R, Juglard G, Hamid C, Boudrie H, Van Haverbeke O, Liagre A.
Obes Surg . 2021 Jun;31(6):2537-2544.

Rationale for inclusion: One anastomosis gastric bypass is a recent bariatric procedure that also carries risk of internal hernia. It can occur years after index operation, CT scan is common mode of diagnosis, and majority are managed via laparoscopy.

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Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis.
Rogalski P, Swidnicka-Siergiejko A, Wasielica-Berger J, Zienkiewicz D, Wieckowska B, Wroblewski E, Baniukiewicz A, Rogalska-Plonska M, Siergiejko G, Dabrowski A, Daniluk J.
SurgEndosc. 2021 Mar;35(3):1067-87.

Rationale for inclusion: Reviews efficacy of endoscopic management of postoperative leaks and fistulas following bariatric surgery. Acute care surgeons may encounter these complications and coordination with advanced endoscopist may be essential to successful management.

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Association of Race With Bariatric Surgery Outcomes
Wood MH, Carlin AM, Ghaferi AA, Varban OA, Hawasli A, Bonham AJ, Birkmeyer NJ, Finks JF.
JAMA Surg. 2019 May 1;154(5):e190029

Rationale for Inclusion: This study is an analysis of the Michigan Bariatric Surgery Collaborative consortium identifying racial disparities among bariatric surgical patient outcomes.

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Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort
Schauer DP, Feigelson HS, Koebnick C, Caan B, Weinmann S, Leonard AC, Powers JD, Yenumula PR, Arterburn DE.
Ann Surg. 2019 Jan;269(1):95-101.

Rationale for Inclusion: This is a large, multisite cohort analysis of the incidence of cancer in bariatric surgery patients identifying lower rates.

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A Prospective Study of the Conservative Management of Asymptomatic Preoperative and Postoperative Gallbladder Disease in Bariatric Surgery.
Pineda O, Maydón HG, Amado M, Sepúlveda EM, Guilbert L, Espinosa O, Zerrweck C.
Obes Surg. 2017 Jan;27(1):148-153.

Rationale for inclusion: A Prospective study for the management of cholelithiasis in bariatric patients. Cholelithiasis one of the most common complications after bariatric surgery, commonly seen by EGS surgeons. Low percentage actually require surgery so if diagnosed conservative management appropriate.

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Reoperative Surgery for Management of Early Complications After Gastric Bypass.
Augustin T, Aminian A, Romero-Talamás H, Rogula T, Schauer PR, Brethauer SA.
Obes Surg. 2016 Feb;26(2):345-9.

Rationale for inclusion: Recent study evaluating early 30 day reoperations due to complications after LRYGB. Included bleeding, obstruction or leak. These complications may present to the acute care surgeon on call requiring intervention.

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Internal Hernia After Laparoscopic Antecolic Roux-en-Y Gastric Bypass.
Al-Mansour MR, Mundy R, Canoy JM, Dulaimy K, Kuhn JN, Romanelli J.
Obes Surg. 2015 Nov;25(11):2106-11.

Rationale for inclusion: This is an important study looking at a complication that is common and often presents years after weight loss surgery which acute care surgeons may be faced with managing. Internal hernia is a potentially fatal complication and CT findings arent always positive. Time is critical and diagnostic laparoscopy gold standard. If no bariatric surgeon avaialble acute care surgeon needs to intervene.

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Emergency endoscopy for gastrointestinal bleeding after bariatric surgery. Therapeutic algorithm.
García-García ML, Martín-Lorenzo JG, Torralba-Martínez JA, Lirón-Ruiz R, Miguel Perelló J, Flores Pastor B, Pérez Cuadrado E, Aguayo Albasini JL.
Cir Esp. 2015 Feb;93(2):97-104.

Rationale for inclusion: This study looked specifically at postoperative GI bleeding (GIB)v in bariatric surgery. GIB is a complication seen and may need intervention. Endoscopic techniques are often adequate and necessary.

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Intussusception after Roux-en-Y gastric bypass.
Stephenson D, Moon RC, Teixeira AF, Jawad MA.
Surg Obes Relat Dis. 2014 Jul-Aug;10(4):666-70.

Rationale for inclusion: This is a 10-year review of patients presenting with intussusception after RYGB. This is a rare but serious complication. Often presents with upper abdominal pain, can be mistaken for other surgical processes. Requires surgical intervention to avoid bowel necrosis. Acute care surgeons need to be aware in order to manage timely.

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Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy.
Salinas J, Barros D, Salgado N, Viscido G, Funke R, Pérez G, Pimentel F, Boza C.
Surg Endosc. 2014 Apr;28(4):1083-9.

Rationale for inclusion: This study is one of the few looking at the very rare but serious complication of portmesenteric venous thrombosis (PSMV) thrombosis. It often presents as abdominal pain, may require exploration for bowel necrosis/splenectomy and may need to be managed by an acute care surgeon.

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Complicated gallstones after laparoscopic sleeve gastrectomy.
Sioka E, Zacharoulis D, Zachari E, Papamargaritis D, Pinaka O, Katsogridaki G, Tzovaras G.
J Obes. 2014;2014:468203.

Rationale for inclusion: Another study demonstrating the common presentation after bariatric surgery of complicated cholelithiasis. This often requires surgery and can be technically difficult postop and may warrant early cholecystectomy. The oncall acute care surgeon will often see and need to manage these patients.

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Abdominal pain after gastric bypass: suspects and solutions.
Greenstein AJ, O'Rourke RW.
Am J Surg. 2011 Jun;201(6):819-27.

Rationale for inclusion: This article reviews the most common causes of abdominal pain after gastric bypass surgery as abdominal pain is one of the most common reason for surgical consult. Post RYGB often warrants surgical exploration.

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Bowel obstruction in bariatric and nonbariatric patients: major differences in management strategies and outcome.
Martin MJ, Beekley AC, Sebesta JA.
Surg Obes Relat Dis. 2011 May-Jun;7(3):263-9.

Rationale for inclusion: A very large comparison of bowel obstruction in bariatric versus nonbariatric patients was analyzed. The majority of postbaratric patients required surgery whereas the majority of nonbariatric were managed conservatively. This demonstrates that the importance of understanding the differences in this common complication between groups.

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The "O" sign, a simple and helpful tool in the diagnosis of laparoscopic adjustable gastric band slippage.
Pieroni S, Sommer EA, Hito R, Burch M, Tkacz JN.
AJR Am J Roentgenol. 2010 Jul;195(1):137-41.

Rationale for inclusion: This study looks specifically at radiographic diagnosis of slipped gastric band. With increasing number of bands performed in the last decade, complications need to be recognized for early intervention.

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