The Experts below are selected from a list of 129 Experts worldwide ranked by ideXlab platform
Keith A. Kelly - One of the best experts on this subject based on the ideXlab platform.
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Use of an ileal roux limb to prevent the roux stasis syndrome
Journal of Gastrointestinal Surgery, 1997Co-Authors: Michinaga Takahashi, Bao-lien Nguyen Tu, Edoardo Leombruni, Keith A. KellyAbstract:The aim of this study was to determine whether the use of an ileal Roux limb, rather than a jejunal Roux limb, would prevent the Roux stasis syndrome that can occur after Roux gastrectomy. An ileal Roux limb was constructed in eight dogs and anastomosed to the gastric remnant after distal hemigastrectomy. Flow of chyme through the jejunum was preserved via an ileojejunostomy and a Jejunoileostomy. Six dogs with distal gastrectomy and a conventional Roux gastrojejunostomy served as a control group. Chronic enteric recording electrodes and intraluminal, open-tipped pressure catheters were implanted in all dogs. After recovery, the electrical activity and motility of the Roux limbs and the rates of gastric emptying of liquids and solids were measured. Dogs with a Roux gastroileostomy had a slower frequency of pacesetter potentials in the Roux limb, a greater Roux motility index, and a faster rate of gastric emptying of liquids and solids than did dogs with a Roux gastrojejunostomy. Stomal ulcers, however, developed in seven of the eight ileal Roux limbs but in none of the jejunal Roux limbs. It was concluded that Roux gastroileostomy does ameliorate the Roux stasis syndrome, but there is a greater risk of stomal ulceration in the limb.
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Use of an ileal roux limb to prevent the roux statis syndrome
Journal of Gastrointestinal Surgery, 1997Co-Authors: Michinaga Takahashi, Edoardo Leombruni, Baolien Nguyen Tu, Keith A. KellyAbstract:Abstract The aim of this study was to determine whether the use of an ileal Roux limb, rather than a jejunal Roux limb, would prevent the Roux statis syndrome that can occur after Roux gastrectomy. An ileal Roux limb was constructed in eight dogs and anastomosed to the gastric remnant after distal hemigastrectomy. Flow of chyme through the jejunum was preserved via an ileojejunostomy and a Jejunoileostomy. Six dogs with distal gastrectomy and a conventional Roux gastrojejunostomy served as a control group. Chronic enteric recording electrodes and intraluminal, open-tipped pressure catherers were implanted in all dogs. After recovery, the electrical activity and motility of the Roux limbs and the rates of gastric emptying of liquids and solids were measured. Dogs with a Roux gastroileostomy had a slower frequency of pacesetter potentials in the Roux limb, a greater Roux motility index, and a faster rate of gastric emptying of liquids and solids than did dogs with a Roux gastrojejunostomy. Stomal ulcers, however, developed in seven of the eight ileal Roux limbs but in none of the jejunal Roux limbs. It was concluded that Roux gastroileostomy does ameliorate the Roux statis syndrome, but there is a greater risk of stomal ulceration in the limb.
Michinaga Takahashi - One of the best experts on this subject based on the ideXlab platform.
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Use of an ileal roux limb to prevent the roux stasis syndrome
Journal of Gastrointestinal Surgery, 1997Co-Authors: Michinaga Takahashi, Bao-lien Nguyen Tu, Edoardo Leombruni, Keith A. KellyAbstract:The aim of this study was to determine whether the use of an ileal Roux limb, rather than a jejunal Roux limb, would prevent the Roux stasis syndrome that can occur after Roux gastrectomy. An ileal Roux limb was constructed in eight dogs and anastomosed to the gastric remnant after distal hemigastrectomy. Flow of chyme through the jejunum was preserved via an ileojejunostomy and a Jejunoileostomy. Six dogs with distal gastrectomy and a conventional Roux gastrojejunostomy served as a control group. Chronic enteric recording electrodes and intraluminal, open-tipped pressure catheters were implanted in all dogs. After recovery, the electrical activity and motility of the Roux limbs and the rates of gastric emptying of liquids and solids were measured. Dogs with a Roux gastroileostomy had a slower frequency of pacesetter potentials in the Roux limb, a greater Roux motility index, and a faster rate of gastric emptying of liquids and solids than did dogs with a Roux gastrojejunostomy. Stomal ulcers, however, developed in seven of the eight ileal Roux limbs but in none of the jejunal Roux limbs. It was concluded that Roux gastroileostomy does ameliorate the Roux stasis syndrome, but there is a greater risk of stomal ulceration in the limb.
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Use of an ileal roux limb to prevent the roux statis syndrome
Journal of Gastrointestinal Surgery, 1997Co-Authors: Michinaga Takahashi, Edoardo Leombruni, Baolien Nguyen Tu, Keith A. KellyAbstract:Abstract The aim of this study was to determine whether the use of an ileal Roux limb, rather than a jejunal Roux limb, would prevent the Roux statis syndrome that can occur after Roux gastrectomy. An ileal Roux limb was constructed in eight dogs and anastomosed to the gastric remnant after distal hemigastrectomy. Flow of chyme through the jejunum was preserved via an ileojejunostomy and a Jejunoileostomy. Six dogs with distal gastrectomy and a conventional Roux gastrojejunostomy served as a control group. Chronic enteric recording electrodes and intraluminal, open-tipped pressure catherers were implanted in all dogs. After recovery, the electrical activity and motility of the Roux limbs and the rates of gastric emptying of liquids and solids were measured. Dogs with a Roux gastroileostomy had a slower frequency of pacesetter potentials in the Roux limb, a greater Roux motility index, and a faster rate of gastric emptying of liquids and solids than did dogs with a Roux gastrojejunostomy. Stomal ulcers, however, developed in seven of the eight ileal Roux limbs but in none of the jejunal Roux limbs. It was concluded that Roux gastroileostomy does ameliorate the Roux statis syndrome, but there is a greater risk of stomal ulceration in the limb.
Dennis Hong - One of the best experts on this subject based on the ideXlab platform.
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The Effect of Bariatric Surgery on Oral Antibiotic Absorption: a Systematic Review
Obesity Surgery, 2020Co-Authors: Sama Anvari, Aristithes G. Doumouras, Dennis HongAbstract:Purpose The purpose of this study was to conduct a systematic review of the existing literature to determine the effect of bariatric surgery on various pharmacokinetic parameters of oral antibiotic absorption as well as overall patient outcomes. Materials and Methods MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to February 2020. Outcomes of interest included change in pharmacokinetic parameters of oral antibiotics administered to patients following bariatric surgery, using variables such as maximum plasma concentration (Cmax), time to reach maximum plasma concentration (Tmax), area under the concentration-time curve (AUC), clearance, and volume of distribution. MINORS and Cochrane risk of bias tools were used to assess quality of evidence. Results Ten studies with 100 patients assessing 8 oral antibiotics were included. The majority (77%) of patients underwent Roux-en-Y gastric bypass (RYGB), with fewer undergoing ventral banded gastroplasty (VBG) (14%), Jejunoileostomy (6%), and jejunoileal bypass (3%). Antibiotic classes investigated included beta-lactams (5 studies), fluoroquinolones (2 studies), macrolides (2 studies), and oxazolidinones (1 study). Heterogeneity between studies precluded meaningful pooling or meta-analysis of data. Overall risk of bias was fair. Conclusion Patients given oral beta-lactams and macrolides warrant close monitoring due to unpredictable absorption post-bariatric surgery, whereas oral fluoroquinolones and linezolid may not be affected. Several studies also showed decreased absorption following RYGB, as well as lower serum exposure in patients with obesity compared to non-obese controls. Clinicians should monitor patients on a case-by-case basis for signs of antibiotic failure or toxicity and reassess dosing accordingly.
G. B. Cadière - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic conversion of Roux-en-Y gastric bypass to biliopancreatic diversion
Surgical Endoscopy, 2010Co-Authors: G. Dapri, J. Himpens, G. B. CadièreAbstract:Background This report describes the laparoscopic conversion of a Roux-en-Y gastric bypass (RYGBP) to biliopancreatic diversion (BPD). Case report In January 1995, a 47-year-old woman with a body mass index (BMI) of 54 kg/m^2 benefited from a silicon ring vertical banded gastroplasty (SRVBG) for morbid obesity. She showed significant weight loss and reached a BMI of 30 kg/m^2. After 7 years, she experienced weight regain (BMI, 34.5 kg/m^2), so a laparoscopic conversion to RYGBP was proposed. The patient again had a successful weight loss (BMI, 26 kg/m^2), but 6 years later, she mentioned a weight regain (BMI, 33 kg/m^2) with invalidating retrosternal pain. The nutritionist’s analysis of the patient showed a certain modification of the alimentary character with frequent meals (grazing/polyphagia), and the psychologist’s consultation identified an important binge-eating disorder. A laparoscopic conversion of RYGBP to BPD was proposed. The procedure consisted of (1) adhesiolysis and reduction of a hiatal hernia, (2) sectioning of the gastric pouch proximally to the gastrojejunostomy, (3) resection of the fundus of the gastric remnant excluded by the previous SRVBG, (4) restoration of the continuity of the stomach between the gastric pouch and the gastric remnant, (5) resection of the gastric antrum and pylorus, (6) deconstruction of the previous jejunojejunostomy, (7) restoration of the continuity of the small bowel, (8) measurement of the new common and alimentary limbs and construction of the Jejunoileostomy, (9) closure of the mesenteric defect, (10) construction of the gastroileostomy, (11) closure of Petersen’s space, and (12) repair of the hiatal hernia followed by a leak test. Results The operative time was 320 min, and the blood loss was 380 ml. The patient had an uneventful recovery and was discharged on postoperative day 5. Her BMI was 30.5 kg/m^2 after 3 months and 26 kg/m^2 after 6 months. The barium swallow showed good transit through the gastrointestinal tract. Conclusions The laparoscopic conversion of RYGBP to BPD is technically feasible and effective during the short term for cases of repeated weight regain.
Charles E Wills - One of the best experts on this subject based on the ideXlab platform.
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Long-term Follow-up of Jejunoileal Bypass Patients with Preoperative Cirrhosis of the Liver
Obesity Surgery, 1994Co-Authors: Charles E WillsAbstract:Though obesity, alcohol abuse and Jejunoileostomy are often a dangerous combination, exceptions do exist. This paper reports on the long-term outcome of 12 patients who had hepatic cirrhosis prior to Jejunoileostomy. The six patients who refrained from or significantly restricted alcohol intake following Jejunoileostomy all survived a minimum of 2 years following surgery. Four of these patients, now 6 to 25 years post surgery, are still living as of August 1993.