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Article ; Online: Incidence of symptomatic gallstones after bariatric surgery: the impact of expectant management.

Nogueiro, Jorge / Santos-Sousa, Hugo / Ribeiro, Miguel / Cruz, Filipe / Pereira, André / Resende, Fernando / Costa-Pinho, André / Preto, John / Sousa-Pinto, Bernardo / Lima-da-Costa, Eduardo / Carneiro, Silvestre

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 160

Abstract: Background: Bariatric surgery is the most effective treatment for sustained weight reduction and obesity-related comorbidities. The development of gallstones as a result of rapid weight loss is a well-known consequence of bariatric procedures. It ... ...

Abstract	Background: Bariatric surgery is the most effective treatment for sustained weight reduction and obesity-related comorbidities. The development of gallstones as a result of rapid weight loss is a well-known consequence of bariatric procedures. It remains unclear, if there is an increased risk of these gallstones becoming symptomatic. Methods: A retrospective analysis of 505 consecutive patients submitted to either Roux-en-Y Gastric Bypass or Sleeve Gastrectomy between January and December 2019 was performed. The aim of our study was to determine the incidence of symptomatic cholelithiasis in asymptomatic patients with their gallbladder in situ after bariatric surgery and to identify potential risk factors for its development. Results: Of the 505 patients included, 79 (15.6%) underwent either previous cholecystectomy. (n = 67, 84.8%) or concomitant cholecystectomy during bariatric surgery (n = 12, 15.2%). Among the remaining 426 (84.4%) patients, only 8 (1.9%) became symptomatic during the 12-month follow-up period. When compared with patients who remained asymptomatic, they had a higher median preoperative BMI (47.0 vs. 42.8, p = 0.046) and prevalence of cholelithiasis on preoperative ultrasound (62.5% vs. 10.7%, p = 0.001). Multivariate analysis revealed preoperative BMI and cholelithiasis on preoperative ultrasound as independent risk factors for symptomatic biliary disease (OR 1.187, 95%CI 1.025-1.376, p = 0.022 and OR 10.720, 95%CI 1.613-71.246, p = 0.014, respectively). Conclusion: Considering a low incidence of symptomatic gallstones after bariatric surgery, concomitant cholecystectomy should only be performed in symptomatic patients undergoing bariatric surgery. Preoperative factors, such as a higher BMI and positive ultrasound for cholelithiasis, may be related to the development of symptomatic gallstones.
MeSH term(s)	Humans ; Gallstones/surgery ; Retrospective Studies ; Incidence ; Watchful Waiting ; Obesity, Morbid/surgery ; Bariatric Surgery/adverse effects ; Gastric Bypass/adverse effects ; Gastrectomy/adverse effects
Language	English
Publishing date	2023-04-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02904-6
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Article ; Online: Roux-en-Y gastric bypass and sleeve gastrectomy as revisional bariatric procedures after adjustable gastric banding: a retrospective cohort study.

Santos-Sousa, Hugo / Nogueiro, Jorge / Lindeza, Luis / Carmona, Maria Neves / Amorim-Cruz, Filipe / Resende, Fernando / Costa-Pinho, André / Preto, John / Sousa-Pinto, Bernardo / Carneiro, Silvestre / Lima-da-Costa, Eduardo

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 441

Abstract: Introduction: The frequency of revisional bariatric surgery is increasing, but its effectiveness and safety are not yet fully established. The aim of our study was to compare short-term outcomes of primary (pRYGB and pSG) and revisional bariatric ... ...

Abstract	Introduction: The frequency of revisional bariatric surgery is increasing, but its effectiveness and safety are not yet fully established. The aim of our study was to compare short-term outcomes of primary (pRYGB and pSG) and revisional bariatric surgeries (rRYGB and rSG). Methods: We performed a retrospective cohort study assessing all patients submitted to primary and revisional (after a failed AGB) RYGB and SG in 2019. Each patient was followed-up at 6 months and 12 months after surgery. We compared pRYGB vs. rRYGB, pSG vs. rSG and rRYGB vs. rSG on weight loss, surgical complications, and resolution of comorbidities. Results: We assessed 494 patients, of which 18.8% had undergone a revisional procedure. Higher weight loss at 6 and 12 months was observed in patients undergoing primary vs. revisional procedures. Patients submitted to rRYGB lost more weight than those with rSG (%EWL 12 months = 82.6% vs. 69.0%, p < 0.001). Regarding the resolution of obesity-related comorbidities, diabetes resolution was more frequent in pRYGB than rRYGB (54.2% vs. 25.0%; p = 0.038). Also, 41.7% of the patients who underwent rRYGB had dyslipidemia resolution vs. 0% from the rSG group (p = 0.035). Dyslipidemia resolution was also more common in pSG vs. rSG (68.6% vs. 0.0%; p = 0.001). No significant differences in surgical complications were found. Conclusion: Revisional bariatric surgery is effective and safe treating obesity and related comorbidities after AGB. Primary procedures appear to be associated with better weight loss outcomes. Further prospective studies are needed to better understand the role of revisional bariatric surgery.
MeSH term(s)	Humans ; Bariatric Surgery ; Bariatrics ; Dyslipidemias ; Gastrectomy ; Gastric Bypass ; Gastroplasty ; Obesity/surgery ; Retrospective Studies ; Weight Loss
Language	English
Publishing date	2023-11-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03174-y
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Article ; Online: Risk and Prophylactic Management of Gallstone Disease in Bariatric Surgery: a Systematic Review and A Bayesian meta-analysis.

Amorim-Cruz, Filipe / Santos-Sousa, Hugo / Ribeiro, Miguel / Nogueiro, Jorge / Pereira, André / Resende, Fernando / Costa-Pinho, André / Preto, John / Lima-da-Costa, Eduardo / Sousa-Pinto, Bernardo

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2023 Volume 27, Issue 2, Page(s) 433–448

Abstract: Background: The frequency and management of gallstone disease (GD) in bariatric patients, including the role of routine prophylactic concomitant cholecystectomy (CCY), are still a matter of debate. This study aims to assess the risk of de novo GD in ... ...

Abstract	Background: The frequency and management of gallstone disease (GD) in bariatric patients, including the role of routine prophylactic concomitant cholecystectomy (CCY), are still a matter of debate. This study aims to assess the risk of de novo GD in patients undergoing bariatric surgery (BS) and their predictive factors, as well as mortality and morbidity in prophylactic CCY compared to BS alone. Methods: We performed a systematic review, searching PubMed, EMBASE, and Web of Science until April 2021. We performed a Bayesian meta-analysis to estimate the risk of GD development after BS and the morbidity and mortality associated with BS alone versus BS + prophylactic CCY. Sources of heterogeneity were explored by meta-regression analysis. Results: The risk of de novo post bariatric GD was 20.7% (95% credible interval [95% CrI] = 13.0-29.7%; I Conclusion: The risk of de novo symptomatic GD after BS is not substantially high. Although mortality is similar between groups, odds of major postoperative complications were higher in patients submitted to BS + prophylactic CCY. It is still arguable if prophylactic CCY is a fitting approach for patients with a preoperative lithiasic gallbladder.
MeSH term(s)	Female ; Humans ; Bariatric Surgery/adverse effects ; Bayes Theorem ; Cholecystectomy/adverse effects ; Cholelithiasis/surgery ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control
Language	English
Publishing date	2023-01-10
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-022-05567-8
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Zs.A 5207: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Surgery for Perforated Peptic Ulcer: Is Laparoscopy a New Paradigm?

Pereira, André / Santos Sousa, Hugo / Gonçalves, Diana / Lima da Costa, Eduardo / Costa Pinho, André / Barbosa, Elisabete / Barbosa, José

Minimally invasive surgery

2021 Volume 2021, Page(s) 8828091

Abstract: Introduction: Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the ... ...

Abstract	Introduction: Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. Methods: Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. Results: During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; Conclusion: Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.
Language	English
Publishing date	2021-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2627964-2
ISSN	2090-1453 ; 2090-1445
ISSN (online)	2090-1453
ISSN	2090-1445
DOI	10.1155/2021/8828091
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Article ; Online: Early Postoperative Bleeding After Laparoscopic Roux-En-Y Gastric Bypass: a Single Center Analysis.

Pereira, André / Santos, Rui Ferreira / Costa-Pinho, André / Silva, Alexandre / Nogueiro, Jorge / Carneiro, Silvestre / Lima-da-Costa, Eduardo / Santos-Sousa, Hugo / Preto, John

Obesity surgery

2022 Volume 32, Issue 6, Page(s) 1902–1908

Abstract: Purpose: Early postoperative bleeding is a common complication after laparoscopic Roux-en-Y gastric bypass (LRYGB) and is associated with significant morbidity. We aimed to identify predictors of early postoperative bleeding after LRYGB and characterize ...

Abstract	Purpose: Early postoperative bleeding is a common complication after laparoscopic Roux-en-Y gastric bypass (LRYGB) and is associated with significant morbidity. We aimed to identify predictors of early postoperative bleeding after LRYGB and characterize hemorrhagic events and 30-day postoperative outcomes. Material and methods: We conducted a retrospective cohort study regarding all patients submitted to LRYGB in 2019 at a high-volume obesity center. Early postoperative bleeding was defined as any clinically significant evidence of hemorrhage in the early postoperative period. Demographic, preoperative, and intraoperative factors were evaluated for associations with postoperative bleeding. Postoperative outcomes were compared between patients with and without hemorrhage. Results: Of 340 patients submitted to LRYGB, 14 (4.1%) had early postoperative bleeding. Patients with bleeding had an increased preoperative left hepatic lobe diameter (8.4 vs. 7.3 cm, p = 0.048). Prior cholecystectomy (28.6 vs. 14.5%) and previous bariatric surgery (35.7 vs. 23.9%) tended to be more prevalent among these patients. Bleeding occurred at a median time of 31.2 [IQR 19.7-38.5] h. Thirteen patients presented with intraluminal bleeding and one with extraluminal bleeding. Melena was the most common symptom. All hemorrhages were clinically diagnosed, and 92.9% were managed conservatively. Postoperative bleeding was associated with longer hospital stay (3.5 vs. 2.0 days), higher reintervention (7.1 vs. 0%), and readmission (14.3 vs. 0%), all p < 0.05. Conclusions: Bleeding was the most frequent early complication after LRYGB. Patients with hepatomegaly and prior surgeries may have technically challenging LRYGB and should be carefully assessed. Perioperative strategies should be encouraged in high-risk patients to prevent bleeding.
MeSH term(s)	Gastric Bypass/adverse effects ; Humans ; Laparoscopy/adverse effects ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Postoperative Hemorrhage/epidemiology ; Postoperative Hemorrhage/etiology ; Postoperative Hemorrhage/therapy ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-022-05973-6
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Article ; Online: Vitamin B Complex Deficiency After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy-a Systematic Review and Meta-Analysis.

Nunes, Rita / Santos-Sousa, Hugo / Vieira, Sofia / Nogueiro, Jorge / Bouça-Machado, Raquel / Pereira, André / Carneiro, Silvestre / Costa-Pinho, André / Lima-da-Costa, Eduardo / Preto, John / Group, C R I-O

Obesity surgery

2022 Volume 32, Issue 3, Page(s) 873–891

Abstract: Bariatric surgery, although an effective method, still has complications, like nutritional deficiencies. Our aim was to summarize the evidence on the frequency of complex B vitamin deficiencies in studies comparing Roux-en-Y gastric bypass (RYGB) and ... ...

Abstract	Bariatric surgery, although an effective method, still has complications, like nutritional deficiencies. Our aim was to summarize the evidence on the frequency of complex B vitamin deficiencies in studies comparing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). We included 25 studies for qualitative synthesis and 21 studies for quantitative synthesis. Relevant data was extracted, including proportion of patients with deficiency and mean serum vitamin values in 3 different timeframes. B12 and folate were the most prevalent deficiencies. B12 deficiency was more common after RYGB and folate serum mean levels were higher after RYGB. SG causes less nutrient deficiency and is therefore a better technique from this point of view. More studies are needed on B2, B3, and B6 vitamins to draw better conclusions.
MeSH term(s)	Folic Acid ; Gastrectomy/adverse effects ; Gastrectomy/methods ; Gastric Bypass/adverse effects ; Gastric Bypass/methods ; Humans ; Obesity, Morbid/surgery ; Vitamin B Complex ; Vitamin B Deficiency
Chemical Substances	Vitamin B Complex (12001-76-2) ; Folic Acid (935E97BOY8)
Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05783-2
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Article ; Online: Comparative Effectiveness of Bariatric Surgeries in Patients with Type 2 Diabetes Mellitus and BMI ≥ 25 kg/m

Carmona, Maria Neves / Santos-Sousa, Hugo / Lindeza, Luís / Sousa-Pinto, Bernardo / Nogueiro, Jorge / Pereira, André / Carneiro, Silvestre / Costa-Pinho, André / Lima-da-Costa, Eduardo / Preto, John

Obesity surgery

2021 Volume 31, Issue 12, Page(s) 5312–5321

Abstract: Purpose: In patients with type 2 diabetes mellitus (T2DM), bariatric surgery appears to be more effective than medical treatment (MT) at improving glycaemic control and decreasing cardiovascular risk. However, long-term effectiveness has not been ... ...

Abstract	Purpose: In patients with type 2 diabetes mellitus (T2DM), bariatric surgery appears to be more effective than medical treatment (MT) at improving glycaemic control and decreasing cardiovascular risk. However, long-term effectiveness has not been systematically assessed using randomised controlled trials. In this study, we aimed to systematically assess randomised controlled trials, with at least 5 years of follow-up, on bariatric surgery in patients with T2DM and BMI ≥ 25 kg/m Material and methods: PubMed, SCOPUS and Web of Science were searched. We performed a network meta-analysis to evaluate the comparative effectiveness of the different procedures and MT in terms of full T2DM remission, weight loss, complications and cardiometabolic biomarkers. The quality of evidence was assessed using the Cochrane Risk of Bias Tool and CINeMA. Results: We included 11 primary studies. Laparoscopic one-anastomosis gastric bypass (LOAGB) was found to be one of the most effective treatments for full remission of T2DM (I Conclusion: Bariatric surgery seems to be effective for T2DM remission. LOAGB appears to be a good option in this context, and a possible alternative to laparoscopic duodenal switch, but the included primary studies in our review are not sufficiently powered to establish a more definitive conclusion. More studies with longer follow-up times are needed to comprehensively assess bariatric surgery in T2DM.
MeSH term(s)	Bariatric Surgery/methods ; Body Mass Index ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/surgery ; Gastric Bypass/methods ; Humans ; Laparoscopy/methods ; Network Meta-Analysis ; Obesity, Morbid/surgery ; Randomized Controlled Trials as Topic ; Treatment Outcome
Language	English
Publishing date	2021-10-05
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05725-y
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Article ; Online: Correction to: Comparative Effectiveness of Bariatric Surgeries in Patients with Type 2 Diabetes Mellitus and BMI ≥ 25 kg/m

Obesity surgery

2021 Volume 32, Issue 2, Page(s) 571–573

Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05768-1
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Article ; Online: Cerebral and hepatic hydatid disease.

Costa-Pinho, André / Oliveira, Manuel António / Graça, Luís Afonso / Costa-Maia, José

Porto biomedical journal

2016 Volume 1, Issue 4, Page(s) 153–154

Language	English
Publishing date	2016-09-30
Publishing country	United States
Document type	Journal Article
ISSN	2444-8672
ISSN (online)	2444-8672
DOI	10.1016/j.pbj.2016.07.006
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Article ; Online: Roux-en-Y Gastric Bypass Vs Sleeve Gastrectomy in Super Obesity: a Systematic Review and Meta-Analysis.

Gomes-Rocha, Sofia Raquel / Costa-Pinho, André Manuel / Pais-Neto, Carolina Coelho / de Araújo Pereira, André / Nogueiro, Jorge Pedro Martins / Carneiro, Silvestre Porfírio Ramos / Santos-Sousa, Hugo Miguel Teixeira Ferraz / Lima-da-Costa, Eduardo Jorge / Bouça-Machado, Raquel / Preto, John Rodrigues

Obesity surgery

2021 Volume 32, Issue 1, Page(s) 170–185

Abstract: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are safe procedures that may present sub-optimal results in superobesity (SO). A meta-analysis was performed aiming to summarize the available evidence on weight loss ...

Abstract	Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are safe procedures that may present sub-optimal results in superobesity (SO). A meta-analysis was performed aiming to summarize the available evidence on weight loss (primary outcome) and comorbidities resolution of LRYGB and LSG in patients with SO (BMI ≥ 50 kg/m
MeSH term(s)	Gastrectomy/methods ; Gastric Bypass/methods ; Humans ; Laparoscopy/methods ; Obesity/surgery ; Obesity, Morbid/surgery ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2021-10-12
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05745-8
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