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2.1
Gastrectomy
Gastrectomies

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WIKIDATA, Public Domain

Presentation

The case was successfully managed with angiographic embolisation and we present our experience with recommendations for managing this rare but life-threatening complication. [ncbi.nlm.nih.gov]

Entire Body System

  • Surgical Procedure

    Sleeve gastrectomy is a relatively newer bariatric surgical procedure and has become the most common of all bariatric surgeries performed. [ncbi.nlm.nih.gov]

  • Anemia

    […] procedure may be a suitable weight loss tool for individuals who are not appropriate candidates for other types of bariatric surgery (e.g., gastric bypass) due to specific risk factors, including a very high BMI and certain medical conditions such as anemia [advancedobesitysurgery.com.au]

    Anemia usually does not occur for a few years after gastric surgery because iron is stored in moderately large amounts in the bone marrow, where red blood cells are produced. [my.clevelandclinic.org]

    Before surgery, GC patients are likely to have iron-deficiency anemia; and after gastrectomy, patients suffer from low nutritional status and low iron. [ncbi.nlm.nih.gov]

  • Malnutrition

    Outcomes of laparoscopic conversion to SADJ-S or GBP after SADI-S were acceptable, showing clinical improvement of malnutrition, nutritional deficiencies, and quality of life in all cases. Weight regain must be advised. [ncbi.nlm.nih.gov]

    This reduces the calories and nutrients the body absorbs, but it can also lead to malnutrition in some patients. [piedmont.org]

    Malnutrition May result from the dramatic decrease in food intake. This may be addressed through diet and nutritional supplements. Constipation Can lead to abdominal pain but can be treated with a stool softener. [dukemedicine.org]

    Obesity itself is considered a form of malnutrition because deficiencies in both water- and fat-soluble vitamins are seen in the obese population. [todaysdietitian.com]

    Patients should also consider these risks: Malnutrition Protein deficiency Anemia from low iron or vitamin B12 levels (bariatric surgery may require taking special supplements and vitamins) Gastritis Kidney Stones Gallstones To truly understand and discuss [alighterme.com]

Respiratoric

  • Dyspnea

    The main consequence of iron deficiency is hypochromic microcytic anemia with symptoms comprising paleness, dyspnea, tachycardia, and fatigue. [karger.com]

    A temperature elevation or dyspnea may indicate leakage of oral fluids or gastric leaks from the incision around the anastomosis. The most common complication of gastrectomy is dumping syndrome, with fullness and discomfort after meals. [medical-dictionary.thefreedictionary.com]

Gastrointestinal

  • Vomiting

    One year after surgery, 10% of the patients reported that they suffered postprandial vomiting often and 22% rarely. Five years postoperatively, only 8% of subjects describe rarely vomiting. [ncbi.nlm.nih.gov]

  • Early Satiety

    Early satiety or feeling full quickly after food and drink means that you don’t want to eat as much even though your calorie requirements are unchanged (or even increased around the time of your surgery). [mystomachcancersymptoms.com]

    Patients who have early satiety (feeling of fullness after eating), abdominal discomfort, and vomiting may have bile reflux gastritis (also called bilious vomiting), which is also surgically correctable. Many patients also experience weight loss. [medical-dictionary.thefreedictionary.com]

    According to the surgical literature, VSG is considered a restrictive procedure because reduced stomach size causes early satiety and reduced oral intake.5 However, increasing evidence suggests that VSG induces weight loss through other physiological [todaysdietitian.com]

    Patients do not experience normal hunger and have early satiety; in addition, they often experience the early, late, or both dumping syndromes. Meals need to be small and frequent. [academic.oup.com]

  • Loss of Appetite

    This loss of appetite induced by sleeve gastrectomy surgery helps them achieve weight loss. The sleeve gastrectomy is a restrictive weight loss procedure. [weightlosssurgeon.com]

    As the tumor grows, people have abdominal (belly) pain, nausea, and loss of appetite. [spectrumhealth.org]

    Which appetite-stimulating hormone decreases following VSG? a. Peptide-YY b. Growth hormone c. Cholecystokinin d. Ghrelin 3. Which of the following is the key aspect of the mechanism of action by which VSG induces weight loss? a. [todaysdietitian.com]

  • Lactose Intolerance

    intolerance, electrolyte imbalance, food aversions, and sensory enhancement. [todaysdietitian.com]

Cardiovascular

  • Hypertension

    LSG performed at a VAMC resulted in 86.9% improvement in type 2 diabetes mellitus and a 66.1% improvement in hypertension and 74.3% improvement in hyperlipidemia. [ncbi.nlm.nih.gov]

    Complete remission of hypertension was maintained in 46.3%, 48.0%, and 45.5% of patients. [medpagetoday.com]

  • Tachycardia

    The main consequence of iron deficiency is hypochromic microcytic anemia with symptoms comprising paleness, dyspnea, tachycardia, and fatigue. [karger.com]

    […] seen with gastric bypass and caused by rapid emptying of simple carbohydrates into the jejunum-ileum, which leads patients to experience watery diarrhea, diaphoresis (extreme sweating), episodic hypoglycemia, abdominal pain, bloating, stomach rumbling, tachycardia [todaysdietitian.com]

    The signs and symptoms are tachycardia (rapid heart beat), fever, chest pain, and pain in your belly. Most staple line leaks occur within 14 days of surgery. See your doctor immediately if any of these symptoms are present. [obesitycoverage.com]

Psychiatrical

  • Fear

    The most feared complication following laparoscopic sleeve gastrectomy (LSG) is the leak that occurs at the staple line. One method to reduce the risk of leak is the use of reinforcement material at the suture line. [ncbi.nlm.nih.gov]

    The most feared complication of the LSG is gastric leaks (1-2%), typically occurring several days after surgery and mostly located near the GE junction. [ifso.com]

Neurologic

  • Confusion

    […] provider Shaking chills Fast pulse Night sweats Pain, nausea, or vomiting that keeps occurring after you eat Diarrhea beyond the first week after discharge Pain in your upper back, chest, or left shoulder Hiccups that won’t stop or that keep coming back Confusion [fairview.org]

    These symptoms are sweating, fast heart rate, and weakness, feeling tired or mental confusion. Nausea, heartburn and gas are also common. Symptoms can be controlled through eating habits and dietary changes. [nostomachforcancer.org]

    Late dumping syndrome generally includes hypoglycemia, fainting, confusion, and excessive hunger. At one time, dumping syndrome wasn’t believed to occur with VSG because the duodenum remained intact. [todaysdietitian.com]

Workup

Preoperative workup showed a T3N+M0 tumor. After neoadjuvant chemotherapy, laparoscopy was scheduled. Three trocars (5, 12, 5 mm) were placed in the abdomen. The operative field's exposure was improved by temporary percutaneous sutures. [ncbi.nlm.nih.gov]

Serum

  • Dyslipidemia

    Furthermore, several studies have demonstrated the beneficial effects of obesity surgery on reduction of overall mortality, reduction of cardiovascular events and superior control of obesity-related diseases such as type 2 diabetes mellitus, dyslipidemia [ncbi.nlm.nih.gov]

    Comorobidity resolution in LSG/LRYGB were 83%/92% resolved for hypertension, 78%/98% resolved for diabetes mellitus, 75%/78% resolved for dyslipidemia, and 91%/100% resolved for gastroesophageal reflux disease. [sages.org]

    […] intervention for obesity and morbid obesity.3 Bariatric surgery is regarded appropriately as metabolic surgery and is gaining popularity as evidence shows it resolves many comorbid conditions, such as type 2 diabetes, hypertension, obstructive sleep apnea, and dyslipidemia [todaysdietitian.com]

  • Hypochlorhydria

    Methicillin-resistant Staphylococcus aureus (MRSA) enteritis associated with prophylactic cephalosporin administration and hypochlorhydria, after subtotal gastrectomy. Am J Gastroenterol. 86, 791–792 (1991). 13. Shoesmith, J. H. & Shucksmith, H. S. [nature.com]

  • Macrocytic Anemia

    Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 concentration and increased serum concentrations of folate, vitamin E and copper. [ncbi.nlm.nih.gov]

  • Glucose Decreased

    Blood glucose level may be critical: oral or intravenous administration of glucose decreases plasma ghrelin concentration ( 154, 209 ). [doi.org]

Treatment

This study aimed to assess the feasibility and safety of RAG over conventional Laparoscopy-assisted gastrectomy (LAG) for the treatment of GC. [ncbi.nlm.nih.gov]

Prognosis

This study investigated preoperative iron status associated with prognosis after curative gastrectomy for gastric cancer. [ncbi.nlm.nih.gov]

Because of the poor prognosis of gastric carcinoma there is increasing pressure for early detection. Some of the problems in the early detection of gastric carcinoma are discussed together with methods of surveillance of high-risk subjects. [books.google.ro]

Etiology

We speculate that the long-term use of immunosuppressants concomitant with gastrointestinal disorders after gastric surgery was an important causative factor in its etiology. We also investigated the possible treatment for it. [ncbi.nlm.nih.gov]

Recent trend of pylephlebitis in Taiwan: Klebsiella pneumoniae liver abscess as an emerging etiology. Infection. 41, 1137–1143 (2013). 20. Chen, C. et al. [nature.com]

Enterocutaneous fistulae: etiology, treatment, and outcome - a study from South India. Saudi J Gastroenterol. 2011 Nov-Dec. 17 (6):391-5. [Medline]. [Full Text]. WILLIAMS JA, STAMMERS FA. [emedicine.medscape.com]

Epidemiology

Electronic address: [email protected] 4 Department of Nutrition, Ambroise Pare Hospital (AP-HP), University of Versailles Saint Quentin en Yvelines, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Inserm, Population-based Epidemiologic [ncbi.nlm.nih.gov]

Our results, derived from a large-scale epidemiological database, affirm sporadic observations that gastrectomy is associated with PLA 20, 21. [nature.com]

Pathophysiology

However, it is not clear whether high ghrelin level had the pathophysiological role in these symptoms. In both cases, GH and IGF-I levels were within the normal range, and the patients had no clinical features of acromegaly. A. [doi.org]

Prevention

We insert a ‘cardiopexy’ stitch to prevent the new sleeve from migrating up into the chest, which would cause severe reflux, before placing final stitches to prevent twisting of the sleeve, which can cause intermittent obstruction. [circleofcare.com.au]

In this study, the efficacy of sutures and fibrin glue in the prevention of staple leak has been compared retrospectively. [ncbi.nlm.nih.gov]

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