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First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass.

OBJECTIVE: To assess the safety and effectiveness of the laparoscopic sleeve gastrectomy (LSG) as compared to the laparoscopic adjustable gastric band (LAGB), the laparoscopic Roux-en-Y gastric bypass (LRYGB) and the open Roux-en-Y gastric bypass (ORYGB) for the treatment of obesity and obesity-related diseases. BACKGROUND: LSG is a newer procedure being done with increasing frequency. However, limited data are currently available comparing LSG to the other established procedures. We present the first prospective, multiinstitutional, nationwide, clinically rich, bariatric-specific data compar

[2025 Annual data report on bariatric and metabolic surgery in Guangdong Province].

Objective: To analyze the implementation status of bariatric and metabolic surgery and the provincial resource distribution characteristics … and robot-assisted SG for 4 cases (0.2%). No cases of hydrogel balloon therapy or endoscopic sleeve gastroplasty (ESG) were reported. The top 10 hospitals ranked by surgical volume in Guangdong Province in 2025 showed an obvious hierarchical distribution. The cumulative volume proportions of the top 3, top 5 and top 10 hospitals reached 71.8%, 81.8% and 90.6%, …

Surgical treatment of obesity.

More than half of the European population are overweight (body mass index (BMI) > 25 and < 30 kg/m2) and up to 30% are obese (BMI > or = 30 kg/m2). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic e

Gene variants and binge eating as predictors of comorbidity and outcome of treatment in severe obesity.

Melanocortin-4 receptor gene (MC4R) variants are associated with obesity and binge eating disorder (BED), whereas the more prevalent proopiomelanocortin (POMC) and leptin receptor gene (LEPR) mutations are rarely associated with obesity or BED. The complete coding regions of MC4R, POMC, and leptin-binding domain of LEPR were comparatively sequenced in 300 patients (233 women and 67 men; mean +/- SEM age, 42 +/- 1 years; mean +/- SEM body mass index, 43.5 +/- 0.3 kg/m2) undergoing laparoscopic gastric banding. Eating behavior, esophagogastric pathology, metabolic syndrome prevalence, and postop

Pregnancy after bariatric surgery is not associated with adverse perinatal outcome.

OBJECTIVE: The purpose of this study was to investigate the pregnancy outcome of patients after bariatric surgery. STUDY DESIGN: A population-based study was performed that compared all pregnancies of patients with and without previous obesity operations between the years 1988 and 2002. Stratified analyses with the Mantel-Haenszel technique and a multiple logistic regression model were performed to control for confounders. RESULTS: Of the 159210 deliveries that were performed during the study period, 298 deliveries were to patients after bariatric operations. No significant differences regar

Towards an adiposity-related disease framework for the diagnosis and management of obesities.

Obesity is a complex disease that relapses frequently and associates with multiple complications that comprise a worldwide health priority because of its rising prevalence and association with numerous complications, including metabolic disorders, mechanic pathologies, and cancer, among others. Noteworthy, excess adiposity is accompanied by chronic inflammation, oxidative stress, insulin resistance, and subsequent organ dysfunction. This dysfunctional adipose tissue is initially stored in the visceral depot, overflowing subsequently to produce lipotoxicity in ectopic depots like liver, heart,

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… Conventionally, approaches are stepwise, lifestyle interventions represent the first step being followed by the application of anti-obesity drugs, endoscopical procedures (e.i. endoscopic gastroplasty, gastric balloon), and consideration of bariatric surgery [ 32 , 133 ]. … Endoscopic sleeve gastroplasty plus liraglutide versus endoscopic sleeve gastroplasty alone for weight loss. Gastrointest Endosc. 2021;93:1316–1324.e1. doi: 10.1016/j.gie.2020.10.016. 136. Brunaldi VO, Jirapinyo P, de Moura DTH, et al. …

Long-term incidence of microvascular disease after bariatric surgery or usual care in patients with obesity, stratified by baseline glycaemic status: a post-hoc analysis of participants from the Swedish Obese Subjects study.

BACKGROUND: Bariatric surgery is associated with remission of diabetes and prevention of diabetic complications in patients with obesity and … roup (n=2010) underwent gastric bypass (265 [13%]), gastric banding (376 [19%]), or vertical-banded gastroplasty (1369 [68%]). Participants in the control group (n=2037) received usual care. Bodyweight was measured and questionnaires were completed at baseline and at 0·5 years, 1 year, 2 years, 3 years, 4 years, 6 years, 8 years, 10 years, 15 years, and 20 yea …

Obesity Disease and Surgery.

Obesity is a medical disease that is increasing significantly nowadays. Worldwide obesity prevalence doubled since 1980. Obese patients are at great risk for complications with physical and psychological burdens, thus affecting their quality of life. Obesity is well known to have higher risk for cardiovascular diseases, diabetes mellitus, musculoskeletal diseases and shorter life expectancy. In addition, obesity has a great impact on surgical diseases, and elective surgeries in comparison to general population. There is higher risk for wound infection, longer operative time, poorer outcome, an

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… Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity. British Journal of Surgery. 2005;92(5):557–562. doi: 10.1002/bjs.4974. 125. Nguyen N. T., Braley S., Fleming N. W., Lambourne L., Rivers R., Wolfe B. M. … Open versus laparoscopic vertical banded gastroplasty: a randomized controlled double blind trial. Obesity Surgery. 2002;12(6):812–818. doi: 10.1381/096089202320995619. 127. Belizon A., Sardinha C. T., Sher M. E. Converted laparoscopic colectomy: what are the consequences? …

Self-report of gastrointestinal side effects after bariatric surgery.

BACKGROUND: Data on gastrointestinal (GI) side effects of bariatric surgery are limited because of incomplete reporting, cross-sectional samples, and nonstandardized assessments. OBJECTIVE: To report on GI side effects over the first 6 months after Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). SETTING: Academic medical center, United States. METHODS: One hundred forty-four patients completed a standardized clinical interview 6 months after operation, including questions on the occurrence and frequency of episodes of dumping syndrome, vomiting, and plugg

Brachioplasty and concomitant procedures after massive weight loss: a statistical analysis from a prospective registry.

BACKGROUND: A growing number of massive weight loss patients are undergoing brachioplasty. The authors analyzed data from a prospective registry of massive weight loss patients who underwent brachioplasty alone or with concomitant operations to identify statistically significant complications. METHODS: One hundred one massive weight loss patients underwent brachioplasty. Outcome measures included operative time; time since gastric bypass; need for revision; arm liposuction; and complications such as seroma, dehiscence, hematoma, infection, and nerve injury. Univariate analyses were performed

Obesity Management in Adults: A Review.

IMPORTANCE: Obesity affects approximately 42% of US adults and is associated with increased rates of type 2 diabetes, hypertension, cardiova … ight loss of 21% at 72 weeks. Endoscopic procedures (ie, intragastric balloon and endoscopic sleeve gastroplasty) can attain 10% to 13% weight loss at 6 months. Weight loss from metabolic and bariatric surgeries (ie, laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass) ranges from 25% to 30% at 12 months. Maintaining long-term weight loss is difficult …

National prevalence, causes, and risk factors for bariatric surgery readmissions.

BACKGROUND: Readmissions are often used as a quality metric particularly in bariatric surgery. METHODS: Laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy were identified using Current Procedure Terminology codes in the 2012 National Surgical Quality Improvement Program public use file. RESULTS: A total of 18,296 patients were included, 10,080 (55.1%) were laparoscopic Roux en Y gastric bypass, 1,829 (10.0%) were laparoscopic adjustable gastric banding, and 6,387 (34.9%) were laparoscopic sleeve gastrectomy. Among all patients,

Gallbladder pathology in morbid obesity.

BACKGROUND: Obese patients are at increased risk for biliary disease. The prevalence and type of gallbladder pathology in morbidly obese patients was evaluated, and compared with a non-obese control group. METHODS: A consecutive series of obese patients (n=478) who had undergone bariatric surgery with concurrent routine cholecystectomy and a consecutive group of organ donors (n=481) were compared. Gallbladder pathology was defined as: cholelithiasis, cholecystitis, cholesterolosis, or normal pathology. RESULTS: Mean age of obese patients and of donors was 42 +/- 9 and 43 +/- 17 years respect

Patterns of surgical weight loss and resolution of metabolic abnormalities in superobese bariatric adolescents.

PURPOSE: The aim of the study was to compare the baseline and the 18-month follow-up for weight and metabolic characteristics of superobese (SO) (body mass index [BMI] ≥50 kg/m(2)) and morbidly obese (MO) (BMI <50 kg/m(2)) adolescents who participated in a prospective longitudinal study of gastric banding delivered in an adolescent multidisciplinary treatment program. METHODS: Clinical information was extracted from an institutional review board-approved database of bariatric adolescents. Fasting cytokine and acute phase protein serum levels were analyzed by enzyme-linked immunosorbent assay.

Restoring Insulin Secretion (RISE): design of studies of β-cell preservation in prediabetes and early type 2 diabetes across the life span.

OBJECTIVE: The Restoring Insulin Secretion (RISE) Consortium is testing interventions designed to preserve or improve β-cell function in prediabetes or early type 2 diabetes. RESEARCH DESIGN AND METHODS: β-Cell function is measured using hyperglycemic clamps and oral glucose tolerance tests (OGTTs). The adult medication protocol randomizes participants to 12 months of placebo, metformin alone, liraglutide plus metformin, or insulin (3 months) followed by metformin (9 months). The pediatric medication protocol randomizes participants to metformin or insulin followed by metformin. The adult sur

[Duodenogastric and gastroesophageal bile reflux].

This study reviews current data regarding duodenogastric and gastroesophageal bile reflux-pathophysiology, clinical presentation, methods of diagnosis (namely, 24-hour intraluminal bile monitoring) and therapeutic management. Duodenogastric reflux (DGR) consists of retrograde passage of alkaline duodenal contents into the stomach; it may occur due to antroduodenal motility disorder (primary DGR) or may arise following surgical alteration of gastoduodenal anatomy or because of biliary pathology (secondary DGR). Pathologic DGR may generate symptoms of epigastric pain, nausea, and bilious vomitin

Adipose type I interferon signalling protects against metabolic dysfunction.

OBJECTIVE: Low-grade chronic inflammation emerges as a potent driver of insulin resistance and glucose dysregulation in obesity and associated non-alcoholic fatty liver disease (NAFLD). The liver, subcutaneous fat and the immune system participate in disturbances of metabolism. Type I interferon (IFN) signalling initiated by innate and adaptive immunity modulates inflammatory responses consequent to infection. However, little is known about the role of type I IFN signalling in metabolic diseases and the development of NAFLD. DESIGN: We determined the impact of type I IFN signalling by tissue-

Gastric bypass and banding equally improve insulin sensitivity and β cell function.

Bariatric surgery in obese patients is a highly effective method of preventing or resolving type 2 diabetes mellitus (T2DM); however, the remission rate is not the same among different surgical procedures. We compared the effects of 20% weight loss induced by laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery on the metabolic response to a mixed meal, insulin sensitivity, and β cell function in nondiabetic obese adults. The metabolic response to meal ingestion was markedly different after RYGB than after LAGB surgery, manifested by rapid delivery of inges