Pub Date : 2019-06-30DOI: 10.17476/JMBS.2019.8.1.8
Jong-hyuk Ahn, Eun-Kee Bae, Y. Suh, Y. Jeon, Y. Lee, and Yoonseok Heo
Purpose: To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients. Materials and Methods: Patients with BMIs>27.5 kg/m aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS). Results: Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045-0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, <0.05 and <0.05, respectively). Conclusion: Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.
{"title":"Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients","authors":"Jong-hyuk Ahn, Eun-Kee Bae, Y. Suh, Y. Jeon, Y. Lee, and Yoonseok Heo","doi":"10.17476/JMBS.2019.8.1.8","DOIUrl":"https://doi.org/10.17476/JMBS.2019.8.1.8","url":null,"abstract":"Purpose: To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients. Materials and Methods: Patients with BMIs>27.5 kg/m aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS). Results: Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045-0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, <0.05 and <0.05, respectively). Conclusion: Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47655418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-30DOI: 10.17476/JMBS.2019.8.1.22
A. Imam, Harbi Khalayleh, Maya M. Rahat, E. Mavor, G. Pines, and Shimon Sapojnikov
Chylous ascites is a rare complication following bariatric surgeries. Little data is available regarding chylous ascites following bariatric surgeries per se or in association with internal hernias. Herein we present two cases of chylous ascites following Roux-En-Y gastric bypass; the first one is a 60-year-old male who was presented to the ER six months after a gastric bypass operation suffering from abdominal pain, CT scan and upper endoscopy were normal, however chylous ascites and internal hernia were found during exploratory laparoscopy. The second case is a 39-year-old female patient who was admitted three years following the gastric bypass operation and diagnosed to have small bowel obstruction due to internal hernia, and during exploratory laparoscopy a chylous ascites was found.
{"title":"Chylous Ascites Following Bariatric Surgery Report of Two Cases","authors":"A. Imam, Harbi Khalayleh, Maya M. Rahat, E. Mavor, G. Pines, and Shimon Sapojnikov","doi":"10.17476/JMBS.2019.8.1.22","DOIUrl":"https://doi.org/10.17476/JMBS.2019.8.1.22","url":null,"abstract":"Chylous ascites is a rare complication following bariatric surgeries. Little data is available regarding chylous ascites following bariatric surgeries per se or in association with internal hernias. Herein we present two cases of chylous ascites following Roux-En-Y gastric bypass; the first one is a 60-year-old male who was presented to the ER six months after a gastric bypass operation suffering from abdominal pain, CT scan and upper endoscopy were normal, however chylous ascites and internal hernia were found during exploratory laparoscopy. The second case is a 39-year-old female patient who was admitted three years following the gastric bypass operation and diagnosed to have small bowel obstruction due to internal hernia, and during exploratory laparoscopy a chylous ascites was found.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43849388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-30DOI: 10.17476/JMBS.2019.8.1.1
Dongsub Jeon, Sang Hyun Kim, J. Kim, and Yong Jin Kim
{"title":"Impact of Bariatric Surgery on Cardiovascular Risk Reduction in Korean Obese Patients","authors":"Dongsub Jeon, Sang Hyun Kim, J. Kim, and Yong Jin Kim","doi":"10.17476/JMBS.2019.8.1.1","DOIUrl":"https://doi.org/10.17476/JMBS.2019.8.1.1","url":null,"abstract":"","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42255877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-30DOI: 10.17476/JMBS.2019.8.1.18
H. Yoo, and Yong Jin Kim
Bariatric surgery is the most effective and durable treatment for morbidly obese patients. However, there are remained unsolved problems with various types of complications. Superior mesenteric artery syndrome is a rarely known condition occurred following bariatric surgery. We experienced 54-year-old female patient diagnosed with superior mesenteric artery syndrome 5 year later after laparoscopic adjustable gastric banding. Because symptoms have not improved with conservative care, laparoscopic duodenojejunal bypass was successfully performed for this patient.
{"title":"Case Report: Superior Mesenteric Artery Syndrome following Laparoscopic Adjustable Gastric Banding","authors":"H. Yoo, and Yong Jin Kim","doi":"10.17476/JMBS.2019.8.1.18","DOIUrl":"https://doi.org/10.17476/JMBS.2019.8.1.18","url":null,"abstract":"Bariatric surgery is the most effective and durable treatment for morbidly obese patients. However, there are remained unsolved problems with various types of complications. Superior mesenteric artery syndrome is a rarely known condition occurred following bariatric surgery. We experienced 54-year-old female patient diagnosed with superior mesenteric artery syndrome 5 year later after laparoscopic adjustable gastric banding. Because symptoms have not improved with conservative care, laparoscopic duodenojejunal bypass was successfully performed for this patient.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46412027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.17476/JMBS.2018.7.2.49
H. Ahn, Hyuk-Joon Lee, Se Hoon Kang, Gab Joong Kim, Seong Soo Kim, Young-Jin Kim, Wook Kim, Eung Kook Kim, Jonghyuk Kim, Ji Heon Kim, Ji-Hoon Kim, Jin-Jo Kim, S. Ryu, S. Ryu, D. Park, Sungsoo Park, Y. Park, Joong-Min Park, K. Seo, B. Suh, Sang-Hoon Ahn, S. Ahn, J. Ahn, Sang Kuon Lee, J. Lee, Han Hong Lee, Hongchan Lee, Gui-Ae Jeong, Mi Ran Jeong, Ming-Young Cho, Y. Choi, Sang-Moon Han, Sang-Uk Han, K. Hur, Yoonseok Heo, W. Hyung, S. Choi
{"title":"2014-2017 Nationwide Bariatric and Metabolic Surgery Report in Korea","authors":"H. Ahn, Hyuk-Joon Lee, Se Hoon Kang, Gab Joong Kim, Seong Soo Kim, Young-Jin Kim, Wook Kim, Eung Kook Kim, Jonghyuk Kim, Ji Heon Kim, Ji-Hoon Kim, Jin-Jo Kim, S. Ryu, S. Ryu, D. Park, Sungsoo Park, Y. Park, Joong-Min Park, K. Seo, B. Suh, Sang-Hoon Ahn, S. Ahn, J. Ahn, Sang Kuon Lee, J. Lee, Han Hong Lee, Hongchan Lee, Gui-Ae Jeong, Mi Ran Jeong, Ming-Young Cho, Y. Choi, Sang-Moon Han, Sang-Uk Han, K. Hur, Yoonseok Heo, W. Hyung, S. Choi","doi":"10.17476/JMBS.2018.7.2.49","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.2.49","url":null,"abstract":"연세대학교 강남세브란스병원, 중앙대학교병원, 검단탑병원, 단국대학교병원, 가톨릭대학교 성바오로병원, 가천대학교 길병원, 조선대학교병원, 순천향대학교 서울병원, 가톨릭대학교 여의도성모병원, 고려대학교 안산병원, 웰니스병원, 가톨릭대학교 인천성모병원, 전남대학교병원, 계명대학교 동산병원, 분당서울대학교병원, 울산대학교병원, 고려대학교 안암병원, 서울슬림외과, 칠곡경북대학교병원, 고신대학교 복음병원, 인제대학교 해운대백병원, 한림대학교 성심병원, 서울대학교 보라매병원, 서울아산병원, 가톨릭대학교 대전성모병원, 가톨릭대학교 서울성모병원, 가톨릭대학교 의정부성모병원, 서울대학교병원, 가톨릭대학교 성빈센트병원, 성균관대학교 강북삼성병원, 서울365MC병원, 가톨릭관동대학교 국제성모병원, 한양대학교병원, 차의과대학교 강남차병원, 아주대학교병원, 인하대학교병원, 연세대학교 세브란스병원, 이화여자대학교의료원 외과","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42321243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.17476/JMBS.2018.7.2.54
Dong-wook Kim, Dae Hoon Kim, Jeong Goo Kim, M. Son, G. Song, S. Oh, H. Yoo, M. Lee, Sang Kuon Lee, Sang-Il Lee, Y. Jee, Si Eun Hwang, Sang Eok Lee
Current Status of Metabolic and Bariatric Surgery in Daejeon/Chungcheong Area Dong-Wook Kim, Dae Hoon Kim, Jeong Goo Kim, Myoung Won Son, Geum Jong Song, Seong-il Oh, Han Mo Yoo, Moon-Soo Lee, Sang Kuon Lee, Sang-Il Lee, Ye Seob Jee, Si Eun Hwang, Sang Eok Lee Departments of Surgery, Dankook University Hospital, Cheonan, Chungbuk National University Hospital, Cheongju, The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Soonchunhyang University Cheonan Hospital, Cheonan, Cheongju St. Mary’s Hospital, Cheongju, Eulji University Hospital, Chungnam National University Hospital, Daejeon Sun Hospital, Konyang University Hospital, Daejeon, Korea
{"title":"Current Status of Metabolic and Bariatric Surgery in Daejeon/Chungcheong Area","authors":"Dong-wook Kim, Dae Hoon Kim, Jeong Goo Kim, M. Son, G. Song, S. Oh, H. Yoo, M. Lee, Sang Kuon Lee, Sang-Il Lee, Y. Jee, Si Eun Hwang, Sang Eok Lee","doi":"10.17476/JMBS.2018.7.2.54","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.2.54","url":null,"abstract":"Current Status of Metabolic and Bariatric Surgery in Daejeon/Chungcheong Area Dong-Wook Kim, Dae Hoon Kim, Jeong Goo Kim, Myoung Won Son, Geum Jong Song, Seong-il Oh, Han Mo Yoo, Moon-Soo Lee, Sang Kuon Lee, Sang-Il Lee, Ye Seob Jee, Si Eun Hwang, Sang Eok Lee Departments of Surgery, Dankook University Hospital, Cheonan, Chungbuk National University Hospital, Cheongju, The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Soonchunhyang University Cheonan Hospital, Cheonan, Cheongju St. Mary’s Hospital, Cheongju, Eulji University Hospital, Chungnam National University Hospital, Daejeon Sun Hospital, Konyang University Hospital, Daejeon, Korea","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43008130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.17476/JMBS.2018.7.2.58
Jinhyouk Lim, T. Ha
Purpose: The study aimed to analyze changes in patient indicators and surgical indices in relation to bariatric surgery performed at a university hospital and determine the development direction of its obesity center. Materials and Methods: From December 2010 to June 2018, a total of 35 obese patients underwent surgery at the center. Patients’ height, weight, body mass index (BMI), abdominal circumference, and hip circumference before surgery were measured. Laboratory tests were performed to observe changes before and after surgery. Patients underwent Roux-en Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), and postoperative complications were analyzed. Results: A total of 35 patients underwent obesity surgery: 23 with RYGB and 12 with LSG. Postoperative complications occurred: bleeding in one case, abscess in one case, respiratory failure in one case, and incisional hernia in two cases. The mean preoperative weight was 105.1±27.2 kg and postoperative weight was 84.3±19.9 kg. The difference was 20.7±13.5 kg. BMI also decreased from 38.3±8.4 preoperatively to 31.0±6.4 postoperatively by 7.3±4.6. Conclusion: Through our study, we determined that in this hospital, a multidisciplinary team approach to postoperative weight management and health care should be undertaken as well as continuous and systematic management after surgery.
{"title":"Characteristics of Bariatric Surgery Patients in a Single University Hospital","authors":"Jinhyouk Lim, T. Ha","doi":"10.17476/JMBS.2018.7.2.58","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.2.58","url":null,"abstract":"Purpose: The study aimed to analyze changes in patient indicators and surgical indices in relation to bariatric surgery performed at a university hospital and determine the development direction of its obesity center. Materials and Methods: From December 2010 to June 2018, a total of 35 obese patients underwent surgery at the center. Patients’ height, weight, body mass index (BMI), abdominal circumference, and hip circumference before surgery were measured. Laboratory tests were performed to observe changes before and after surgery. Patients underwent Roux-en Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), and postoperative complications were analyzed. Results: A total of 35 patients underwent obesity surgery: 23 with RYGB and 12 with LSG. Postoperative complications occurred: bleeding in one case, abscess in one case, respiratory failure in one case, and incisional hernia in two cases. The mean preoperative weight was 105.1±27.2 kg and postoperative weight was 84.3±19.9 kg. The difference was 20.7±13.5 kg. BMI also decreased from 38.3±8.4 preoperatively to 31.0±6.4 postoperatively by 7.3±4.6. Conclusion: Through our study, we determined that in this hospital, a multidisciplinary team approach to postoperative weight management and health care should be undertaken as well as continuous and systematic management after surgery.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48406941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.17476/JMBS.2018.7.2.64
A. Aktekin, M. Torun
Laparoscopic sleeve gastrectomy is a surgical procedure for patients who want to lose weight. An acute porto-mesenteric vein thrombosis is an infrequent but not rare complication in patients who undergo laparoscopic sleeve gastrectomy. In this article, we present a 40-year-old male patient with body mass index of 47 kg/m was admitted for laparoscopic sleeve gastrectomy. The surgery took about 130 minutes without any hemorrhage. Full enoxaparin prophylaxis, early and full mobilization, and intermittent pneumatic compression stockings were all applied to prevent venous thrombosis. Unfortunately, he applied to our emergency department and diagnosed to have porto-mesenteric vein thrombosis. There was an approximately 60 cm necrotic jejunal segment between 10th and 70th cm after Treitz ligament and was resected. He was discharged on sixth post operative day with prescription of oral warfarin.
{"title":"Portomesenteric Vein Thrombosis after Laparoscopic Sleeve Gastrectomy","authors":"A. Aktekin, M. Torun","doi":"10.17476/JMBS.2018.7.2.64","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.2.64","url":null,"abstract":"Laparoscopic sleeve gastrectomy is a surgical procedure for patients who want to lose weight. An acute porto-mesenteric vein thrombosis is an infrequent but not rare complication in patients who undergo laparoscopic sleeve gastrectomy. In this article, we present a 40-year-old male patient with body mass index of 47 kg/m was admitted for laparoscopic sleeve gastrectomy. The surgery took about 130 minutes without any hemorrhage. Full enoxaparin prophylaxis, early and full mobilization, and intermittent pneumatic compression stockings were all applied to prevent venous thrombosis. Unfortunately, he applied to our emergency department and diagnosed to have porto-mesenteric vein thrombosis. There was an approximately 60 cm necrotic jejunal segment between 10th and 70th cm after Treitz ligament and was resected. He was discharged on sixth post operative day with prescription of oral warfarin.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43001637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.17476/JMBS.2018.7.1.22
J. Y. Park
Bariatric surgery has evolved from the surgical measure to treat morbid obesity into the epochal remedy to treat metabolic syndrome as a whole, which is represented by type 2 diabetes. Numerous clinical trials have unanimously advocated bariatric or metabolic surgery over the non-surgical interventions, demonstrating markedly superior metabolic outcomes not only in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] ＞ 35kg/m 2 ) but also in less obese or even in simply overweight patients. Nevertheless, not all the diabetic patients can achieve the most desirable outcomes, that is, diabetes remission, after metabolic surgery and candidates for metabolic surgery should be selected carefully based on the comprehensive preoperative assessment of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery can be largely classified into 2 groups based the mechanism of action; 1) indices for the preserved pancreatic beta-cell function, such as younger age, shorter duration of diabetes, and higher C-peptide level, and 2) those represent the potential reserve for reduction in insulin resistance, such as higher baseline BMI, and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these predictors to guide clinicians and patients’ joint decision-making process. Among them, 3 models, DiaRem, ABCD, and Individualized Metabolic Surgery (IMS) scores provide intuitive scoring systems which can be simply utilized in the routine clinical practice and have been validated in the independent external cohort. These prediction models need further validation in the various different ethnicities to ensure the universal applicability.
{"title":"Prediction of Diabetes Remission after Bariatric or Metabolic Surgery","authors":"J. Y. Park","doi":"10.17476/JMBS.2018.7.1.22","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.1.22","url":null,"abstract":"Bariatric surgery has evolved from the surgical measure to treat morbid obesity into the epochal remedy to treat metabolic syndrome as a whole, which is represented by type 2 diabetes. Numerous clinical trials have unanimously advocated bariatric or metabolic surgery over the non-surgical interventions, demonstrating markedly superior metabolic outcomes not only in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] ＞ 35kg/m 2 ) but also in less obese or even in simply overweight patients. Nevertheless, not all the diabetic patients can achieve the most desirable outcomes, that is, diabetes remission, after metabolic surgery and candidates for metabolic surgery should be selected carefully based on the comprehensive preoperative assessment of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery can be largely classified into 2 groups based the mechanism of action; 1) indices for the preserved pancreatic beta-cell function, such as younger age, shorter duration of diabetes, and higher C-peptide level, and 2) those represent the potential reserve for reduction in insulin resistance, such as higher baseline BMI, and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these predictors to guide clinicians and patients’ joint decision-making process. Among them, 3 models, DiaRem, ABCD, and Individualized Metabolic Surgery (IMS) scores provide intuitive scoring systems which can be simply utilized in the routine clinical practice and have been validated in the independent external cohort. These prediction models need further validation in the various different ethnicities to ensure the universal applicability.","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44678585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.17476/JMBS.2018.7.1.1
Bariatric Surgery
{"title":"2018 Korean Society for Metabolic and Bariatric Surgery Guidelines","authors":"Bariatric Surgery","doi":"10.17476/JMBS.2018.7.1.1","DOIUrl":"https://doi.org/10.17476/JMBS.2018.7.1.1","url":null,"abstract":"","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45176288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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