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Article ; Online: Long-term Outcomes of Laparoscopic Sleeve Gastrectomy as a Revisional Procedure Following Adjustable Gastric Banding: Variations in Outcomes Based on Indication.

Wickremasinghe, Anagi / Leang, Yit / Johari, Yazmin / Chana, Prem / Alderuccio, Megan / Shaw, Kalai / Laurie, Cheryl / Nottle, Peter / Brown, Wendy / Burton, Paul

Obesity surgery

2023 Volume 33, Issue 12, Page(s) 3722–3739

Abstract: Background: Significant controversy exists regarding the indications and outcomes after laparoscopic adjustable gastric banding (LAGB) conversions to laparoscopic sleeve gastrectomy (LSG).: Aim: To comprehensively determine the long-term outcomes of ... ...

Abstract	Background: Significant controversy exists regarding the indications and outcomes after laparoscopic adjustable gastric banding (LAGB) conversions to laparoscopic sleeve gastrectomy (LSG). Aim: To comprehensively determine the long-term outcomes of sleeve gastrectomy as a revisional procedure after LAGB across a range of measures and determine predictors of outcomes. Methods: Six hundred revision LSG (RLSG) and 1200 controls (primary LSG (PLSG)) were included. Patient demographics, complications, follow-up, and patient-completed questionnaires were collected. Results: RLSG vs controls; females 87% vs 78.8%, age 45 ± 19.4 vs 40.6 ± 10.6 years, p = 0.561; baseline weight 119.7 ± 26.2 vs 120.6 ± 26.5 kg p = 0.961) Conclusion: RLSG provides long-term weight loss, although peri-operative complications are significantly elevated compared to PLSG. Longer-term re-operation rates are elevated compared to PLSG. Four variables predicted worse outcomes: eroded band, multiple prior bands, severe oesophageal dysmotility and elevated baseline weight.
MeSH term(s)	Female ; Humans ; Adult ; Middle Aged ; Gastroplasty/methods ; Obesity, Morbid/surgery ; Treatment Outcome ; Quality of Life ; Retrospective Studies ; Laparoscopy/methods ; Weight Loss ; Gastrectomy/methods ; Reoperation/methods ; Esophageal Motility Disorders/surgery ; Gastric Bypass
Language	English
Publishing date	2023-10-17
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/s11695-023-06886-8
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Zs.A 3381: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Tubularized and Effaced Gastric Cardia Mimicking Barrett Esophagus Following Sleeve Gastrectomy: Protocolized Endoscopic and Histological Assessment With High-resolution Manometry Analysis.

Johari, Yazmin / Budiman, Kenny / Catchlove, William / Laurie, Cheryl / Hebbard, Geoffrey / Norden, Sam / Brown, Wendy A / Burton, Paul

Annals of surgery

2022 Volume 276, Issue 1, Page(s) 119–127

Abstract: Objective: To describe expected endoscopic and histological changes at gastro-esophageal junction (GEJ) and define diagnostic paradigms for Barrett esophagus (BE) postsleeve gastrectomy (SG).: Summary background data: De novo incidence of BE post SG ... ...

Abstract	Objective: To describe expected endoscopic and histological changes at gastro-esophageal junction (GEJ) and define diagnostic paradigms for Barrett esophagus (BE) postsleeve gastrectomy (SG). Summary background data: De novo incidence of BE post SG was reported as high as 18.8%. A confounding factor is the lack of standardized definition of BE post SG, which may differ from the general population due to procedure-induced alterations of GEJ. Methods: Part 1 involved evaluating endoscopic changes of GEJ post SG (N = 567) compared to pre SG (N = 320), utilizing protocolized preoperative screening, postoperative surveillance and synoptic reporting. Part 2 involved dedicated studies examining causes of altered anatomical and mucosal GEJ appearance using histopathology (N = 55) and high-resolution manometry (HRM) (N = 15). Results: Part 1 - A characteristic tubularized cardia segment projecting supra-diaphragmatically was identified and almost exclusive to post SG (0.6% vs.26.6%, P < 0.001). True BE prevalence was low (4.1%pre SG vs. 3.8%post SG, P = 0.756), esophagitis was comparable (32.1% vs. 25.9%, P = 0.056). Part 2 - Histologically-confirmed BE was found in 12/55 patients, but 70.8% had glandular-type gastric mucosa implying tubularized cardia herniation. HRM of tubularized cardia demonstrated concordance of supra-diaphragmatic cardia herniation between endoscopy and HRM (3 cm vs. 3.2 cm, P = 0.168), with frequent elevated isobaric intraluminal pressurizations in supra-and infra-diaphragmatic cardia compartments. Conclusion: A novel appearance of tubularized cardia telescoping supra-diaphragmatically with flattening of gastric folds is common post SG, likely associated with isobaric hyper-pressurization of proximal stomach. incidence of true BE post SG is low in short-intermediate term. These provided a clear framework for approaching endoscopic screening and surveillance, with correct anatomical and mucosal identifications, and clarified key issues of SG and BE.
MeSH term(s)	Barrett Esophagus/pathology ; Cardia/pathology ; Endoscopy, Gastrointestinal/adverse effects ; Gastrectomy/adverse effects ; Humans ; Manometry
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005493
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Article ; Online: Changes in Oesophageal Transit, Macro-Reflux Events, and Gastric Emptying Correlate with Improvements in Gastro-Intestinal Symptoms and Food Tolerance Early Post Sleeve Gastrectomy.

Wickremasinghe, Anagi C / Johari, Yazmin / Yue, Helen / Laurie, Cheryl / Shaw, Kalai / Playfair, Julie / Beech, Paul / Hebbard, Geoffrey / Yap, Kenneth S / Brown, Wendy / Burton, Paul

Obesity surgery

2023 Volume 33, Issue 8, Page(s) 2384–2395

Abstract: Purpose: There are significant alterations in gastro-intestinal function, food tolerance, and symptoms following sleeve gastrectomy (SG). These substantially change over the first year, but it is unclear what the underlying physiological basis for these ...

Abstract	Purpose: There are significant alterations in gastro-intestinal function, food tolerance, and symptoms following sleeve gastrectomy (SG). These substantially change over the first year, but it is unclear what the underlying physiological basis for these changes is. We examined changes in oesophageal transit and gastric emptying and how these correlate with changes in gastro-intestinal symptoms and food tolerance. Material and methods: Post-SG patients undertook protocolised nuclear scintigraphy imaging along with a clinical questionnaire at 6 weeks, 6 months, and 12 months. Results: Thirteen patients were studied: mean age (44.8 ± 8.5 years), 76.9% females, pre-operative BMI (46.9 ± 6.7 kg/m2). Post-operative %TWL was 11.9 ± 5.1% (6 weeks) and 32.2 ± 10.1% (12 months), p-value < 0.0001. There was a substantial increase of meal within the proximal stomach; 22.3% (IQR 12%) (6 weeks) vs. 34.2% (IQR 19.7%) (12 months), p = 0.038. Hyper-accelerated transit into the small bowel decreased from 6 weeks 49.6% (IQR 10.8%) to 42.7% (IQR 20.5%) 12 months, p = 0.022. Gastric emptying half-time increased from 6 weeks 19 (IQR 8.5) to 12 months 27 (IQR 11.5) min, p = 0.027. The incidence of deglutitive reflux of semi-solids decreased over time; 46.2% (6 weeks) vs. 18.2% (12 months), p-value < 0.0001. Reflux score of 10.6 ± 7.6 at 6 weeks vs. 3.5 ± 4.4 at 12 months, (p = 0.049) and regurgitation score of 9.9 ± 3.3 at 6 weeks vs. 6.5 ± 1.7, p = 0.021 significantly reduced. Conclusions: These data demonstrate that there is an increase in the capacity of the proximal gastric sleeve to accommodate substrate over the first year. Gastric emptying remains rapid but reduce over time, correlating with improved food tolerance and reduced reflux symptoms. This is likely the physiological basis for the changes in symptoms and food tolerance observed early post-SG.
MeSH term(s)	Female ; Humans ; Adult ; Middle Aged ; Male ; Gastric Emptying/physiology ; Obesity, Morbid/surgery ; Gastroesophageal Reflux/etiology ; Gastrectomy/methods
Language	English
Publishing date	2023-06-22
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/s11695-023-06695-z
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Article ; Online: The Evaluation of Gastric Emptying Using Nuclear Scintigraphy Compared to Three-Dimensional Multi-detector Computed Tomography (3D-MDCT) Gastric Volumetry in the Assessment of Poor Weight Loss Following Sleeve Gastrectomy.

Wickremasinghe, Anagi / Ferdinands, Jessica / Johari, Yazmin / Ho, Patrick / Leang, Yit / Yue, Helen / Laurie, Cheryl / Beech, Paul / Nadebaum, David P / Yap, Kenneth S / Hebbard, Geoffrey / Brown, Wendy / Burton, Paul

Obesity surgery

2023 Volume 34, Issue 1, Page(s) 150–162

Abstract: Background: Poor weight loss and weight regain are principal challenges following laparoscopic sleeve gastrectomy (LSG). There is a lack of standardised assessments and diagnostic tests to stratify the status post-LSG and determine whether anatomical or ...

Abstract	Background: Poor weight loss and weight regain are principal challenges following laparoscopic sleeve gastrectomy (LSG). There is a lack of standardised assessments and diagnostic tests to stratify the status post-LSG and determine whether anatomical or physiological problem exists. We aimed to compare nuclear scintigraphy gastric emptying with CT volumetric analysis of sleeve anatomy and determine the impact of anatomy on physiological function and its correlation with weight loss. Materials and methods: Patients greater than 12 months post-LSG were categorised into optimal weight loss (OWL) (n = 29) and poor weight loss groups (PWL) (n = 50). All patients underwent a protocolised nuclear scintigraphy and three-dimensional multi-detector computed tomography (3D-MDCT) gastric volumetry imaging. Results: Post-operative % total weight loss in OWL was 26.2 ± 10.5% vs. 14.2 ± 10.7% in the PWL group (p value < 0.0001). The PWL group had significantly more delayed gastric emptying half-time than OWL (34.1 ± 18.8 vs. 19.5 ± 4.7, p value < 0.0001). Gastric emptying half-time showed statistically significant correlations with weight loss parameters (BMI; r = 0.215, p value 0.048, %EWL; r = - 0.336, p value 0.002 and %TWL; r = - 0.379, p value < 0.001). The median gastric volume on 3D-MDCT did not differ between the OWL (246 (IQR 50) ml) and PWL group (262 (IQR 129.5) ml), p value 0.515. Nuclear scintigraphy gastric emptying half-time was the most highly discriminant measure. A threshold of 21.2 min distinguished OWL from PWL patients with 86.4% sensitivity and 68.4% specificity. Conclusion: Nuclear scintigraphy is a potentially highly accurate tool in the functional assessment of sleeve gastrectomy physiology. It appears to perform better as a diagnostic test than volumetric assessment. Gastric volume did not correlate with weight loss outcomes. We have established diagnostic criteria of greater than 21 min to assess sleeve failure, which is linked to suboptimal weight loss outcomes.
MeSH term(s)	Humans ; Gastric Emptying ; Obesity, Morbid/surgery ; Laparoscopy/methods ; Gastrectomy/methods ; Weight Loss/physiology ; Tomography, X-Ray Computed ; Radionuclide Imaging ; Tomography ; Treatment Outcome ; Retrospective Studies
Language	English
Publishing date	2023-11-22
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/s11695-023-06951-2
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Article ; Online: Initial radiologic appearance rather than management strategy predicts the outcomes of sleeve gastrectomy leaks.

Catchlove, William / Johari, Yazmin / Forrest, Edward / Au, Amos / Shaw, Kalai / Nottle, Peter / Ellis, Samantha / Brown, Wendy A / Burton, Paul

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

2021 Volume 18, Issue 2, Page(s) 205–216

Abstract: Background: Initial radiologic appearance rather than management strategy predicts the outcomes of sleeve gastrectomy leaks.: Objective: Multiple modalities have been advocated for the treatment of sleeve gastrectomy leak, and there remains no ... ...

Abstract	Background: Initial radiologic appearance rather than management strategy predicts the outcomes of sleeve gastrectomy leaks. Objective: Multiple modalities have been advocated for the treatment of sleeve gastrectomy leak, and there remains no consensus on the best treatment paradigm. For more than 10 years, we have variably attempted luminal occlusive therapies and repeated endoscopic debridement as treatment options. By evaluating the outcomes from these approaches, we aimed to determine whether the first management strategy is superior to the second in terms of outcomes. Methods: Patients were analyzed by group (luminal occlusive therapy versus repeated endoscopic debridement). Leaks were then stratified by radiologic appearance on computed tomography, defined as phlegmon, collection, contrast medium leak, or fistula. The primary outcome was length of stay (LOS). Secondary outcomes were comprehensive complication index and the need for resection. Results: There were 54 patients, with 22 in the luminal occlusion group and 32 in the repeated debridement group. There was no difference in LOS (59.8 ± 41.6 versus 46.5 ± 51.2 days, P = .179) and no difference in the requirement for resection (4 versus 3 resections, p = .425). Subset analysis suggested that patients who underwent operative versus conservative management (P = .006) had a longer LOS. Excluding management strategy, radiologic appearance on admission significantly predicted LOS (P = .0053). Patients presenting with fistula (84 ± 25.4 days) and contrast medium leak (64.1 ± 40 days) had a significantly longer LOS than those diagnosed with phlegmon (13.5 ± 5.5 days). Radiologic appearance was predictive of complication severity (P < .0001) and salvage resection (P = .008). Conclusion: There was no significant difference in outcomes between patients treated with intraluminal occlusion or repeated debridement. Initial radiologic appearance was predictive of LOS and complication severity. This highlights the need for routine use of a validated classification system in studies reporting outcomes and treatment of sleeve leaks.
MeSH term(s)	Anastomotic Leak/diagnostic imaging ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Gastrectomy/adverse effects ; Gastrectomy/methods ; Humans ; Laparoscopy/methods ; Obesity, Morbid/complications ; Reoperation/methods ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274243-8
ISSN	1878-7533 ; 1550-7289
ISSN (online)	1878-7533
ISSN	1550-7289
DOI	10.1016/j.soard.2021.11.010
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Zs.A 6572: Show issues

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Article ; Online: Expected Values of Esophageal Transit and Gastric Emptying Scintigraphy Post-uncomplicated Sleeve Gastrectomy.

Johari, Yazmin / Yue, Helen / Laurie, Cheryl / Hebbard, Geoffrey / Beech, Paul / Yap, Kenneth Sk / Brown, Wendy / Burton, Paul

Obesity surgery

2021 Volume 31, Issue 8, Page(s) 3727–3737

Abstract: Purpose: Sleeve gastrectomy (SG) results in significant anatomical and physiological alterations of the esophagus and stomach, including food tolerance. Currently, there is no consensus on the parameters of abnormal esophageal transit and gastric ... ...

Abstract	Purpose: Sleeve gastrectomy (SG) results in significant anatomical and physiological alterations of the esophagus and stomach, including food tolerance. Currently, there is no consensus on the parameters of abnormal esophageal transit and gastric emptying in this population. We describe standardized esophageal transit and gastric emptying protocols, and define expected values following an uncomplicated SG. Materials and methods: In 43 asymptomatic post-SG patients with optimal weight loss, a standardized liquid and semi-solid (oatmeal) esophageal transit study, plus a 90-min semi-solid gastric emptying study with dynamic 5-s image acquisition to assess gastroesophageal reflux, was performed. Gastric emptying half-time and retention rate was calculated. Esophageal transit and reflux were graded by visual inspection of images. Results: Thirty-one female and 12 male patients participated: mean age 49.0±10.7 years, pre-operative BMI 47.6±7.0 kg/m Conclusions: Rapid gastric emptying with asymptomatic deglutitive and post-prandial gastroesophageal reflux events are common following SG. We have defined the expected values of standardized esophageal transit and gastric emptying scintigraphy specifically tailored to SG patients.
MeSH term(s)	Adult ; Esophagus/diagnostic imaging ; Female ; Gastrectomy ; Gastric Emptying ; Humans ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Radionuclide Imaging
Language	English
Publishing date	2021-06-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-021-05487-7
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Article ; Online: Diagnostic Criteria for Gastro-esophageal Reflux Following Sleeve Gastrectomy.

Lim, Gillian / Johari, Yazmin / Ooi, Geraldine / Playfair, Julie / Laurie, Cheryl / Hebbard, Geoffrey / Brown, Wendy / Burton, Paul

Obesity surgery

2021 Volume 31, Issue 4, Page(s) 1464–1474

Abstract: Background: Gastro-esophageal reflux disease (GERD) post-sleeve gastrectomy (SG) is a controversial issue and diagnostic dilemma. Strong heterogeneity exists in the assessment of reflux post-SG, and better diagnostic tools are needed to characterize ... ...

Abstract	Background: Gastro-esophageal reflux disease (GERD) post-sleeve gastrectomy (SG) is a controversial issue and diagnostic dilemma. Strong heterogeneity exists in the assessment of reflux post-SG, and better diagnostic tools are needed to characterize symptomatic reflux. We aimed to determine the discriminant factors of symptomatic reflux and establish diagnostic thresholds for GERD following SG. Materials and methods: Patients post-SG were categorized into asymptomatic and symptomatic cohorts and completed validated symptom questionnaires. All patients underwent stationary esophageal manometry and 24-h ambulatory pH monitoring. Univariate and multivariate analyses were conducted to determine the strongest discriminant factors for GERD. Results: Baseline characteristics of the asymptomatic cohort (n = 48) and symptomatic cohort (n = 76) were comparable. The median post-operative duration was 7.3 (14.1) vs 7.5 (10.7) months (p = 0.825). The symptomatic cohort was more female predominant (90.8 vs 72.9%, p = 0.008). Reflux scores were significantly higher in the symptomatic group (36.0 vs 10.5, p = 0.003). Stationary manometry parameters were similar, including hiatus hernia prevalence and impaired esophageal motility. The symptomatic cohort had significantly higher total acid exposure, especially while supine (11.3% vs 0.6%, p < 0.001). Univariate and multivariate regressions delineated reflux score and supine acid exposure as discriminant factors for symptomatic reflux. The thresholds for distinguishing symptomatic reflux are as follows: reflux score of 11.5 (sensitivity 84.0%, specificity 68.2%) and supine acid exposure of 2.65% (sensitivity 67.1%, specificity 70.8%). Conclusion: A reflux score of 11.5 or more or supine acid exposure of 2.65% or more should be considered diagnostic in defining symptomatic reflux following SG.
MeSH term(s)	Esophageal pH Monitoring ; Female ; Gastrectomy/adverse effects ; Gastroesophageal Reflux/diagnosis ; Gastroesophageal Reflux/etiology ; Gastroesophageal Reflux/surgery ; Humans ; Manometry ; Obesity, Morbid/surgery
Language	English
Publishing date	2021-01-25
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/s11695-020-05152-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Delayed Gastric Emptying After Sleeve Gastrectomy Is Associated with Poor Weight Loss.

Wickremasinghe, Anagi Chethana / Johari, Yazmin / Laurie, Cheryl / Shaw, Kalai / Playfair, Julie / Beech, Paul / Yue, Helen / Becroft, Louise / Hebbard, Geoffrey / Yap, Kenneth S / Brown, Wendy / Burton, Paul

Obesity surgery

2022 Volume 32, Issue 12, Page(s) 3922–3931

Abstract: Background: Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We aimed to determine if there were specific esophago-gastric ... ...

Abstract	Background: Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We aimed to determine if there were specific esophago-gastric transit and emptying alterations associated with weight regain. Material and methods: Participants greater than 12 months post-SG were categorized into optimal (n = 29) and poor weight loss (PWL) (n = 72). All patients underwent a liquid contrast barium swallow demonstrating normal post-surgical anatomy and a protocolized nuclear scintigraphy designed specifically to characterize gastric emptying following SG. Results: The %total weight loss in the optimal group was 26.2 ± 10.5 vs. 14.3 ± 8.8% in the PWL group (p = 0.001). Scintigraphy showed PWL had relatively increased gastric emptying half-time (GE Conclusion: Gastric emptying half-times greater than 21 min appear to reliably correlate with poor weight loss following SG. Additionally, further elevations above 21 min in emptying half-time increase the risk of poor weight loss. We have shown nuclear scintigraphy represents a simple and accurate diagnostic tool in patients who experience poor weight loss after SG, provided substantially altered reporting references in interpreting nuclear scintigraphy are applied.
MeSH term(s)	Humans ; Obesity, Morbid/surgery ; Gastroparesis/diagnostic imaging ; Gastroparesis/etiology ; Gastrectomy ; Weight Loss/physiology ; Weight Gain ; Gastric Bypass ; Gastric Emptying
Language	English
Publishing date	2022-10-27
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/s11695-022-06323-2
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Article ; Online: Evaluation of the histological variability of core and wedge biopsies in nonalcoholic fatty liver disease in bariatric surgical patients.

Ooi, Geraldine J / Clouston, Andrew / Johari, Yazmin / Kemp, William W / Roberts, Stuart K / Brown, Wendy A / Burton, Paul R

Surgical endoscopy

2020 Volume 35, Issue 3, Page(s) 1210–1218

Abstract: Background: Liver biopsy remains the gold standard for characterizing and evaluating treatment response in nonalcoholic fatty liver disease (NAFLD). Liver heterogeneity and sampling variability can affect the reliability of results. This study aimed to ... ...

Abstract	Background: Liver biopsy remains the gold standard for characterizing and evaluating treatment response in nonalcoholic fatty liver disease (NAFLD). Liver heterogeneity and sampling variability can affect the reliability of results. This study aimed to compare histological variability of intraoperative wedge and core liver biopsies from different lobes in bariatric patients, to better inform surgeons on biopsy method and guide interpretation of results. Methods: We prospectively recruited bariatric surgical patients. Intraoperative core biopsies were taken from the left and right lobe, with a wedge biopsy taken from the left. All biopsies were graded by a specialist liver pathologist, blinded to clinical details and biopsy site. Concordance of histological findings between sites was evaluated. Results: There were 91 participants (72.2% female), mean age 46.8 ± 12.0 years, body mass index 45.9 ± 9.4 kg/m Conclusion: Overall diagnosis of NAFLD or NASH shows good agreement between biopsy sites, but individual components, particularly fibrosis stage, vary significantly. Clinicians should consider biopsies from varied sites, to better assess liver disease severity. These data have important implications in fibrosis assessment of NAFLD and are relevant in the interpretation of histological efficacy of investigational pharmacotherapies. Trial registration: ACTRN12615000875505 (Australian Clinical Trials Register).
MeSH term(s)	Australia ; Bariatrics/methods ; Biopsy/methods ; Female ; Humans ; Liver/pathology ; Liver/surgery ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/pathology ; Non-alcoholic Fatty Liver Disease/surgery ; Prospective Studies ; Reproducibility of Results
Keywords	covid19
Language	English
Publishing date	2020-03-13
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-020-07490-y
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Zs.A 2214: Show issues

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Article ; Online: Bariatric Surgery in Patients with Severe Heart Failure.

Yang, Tze Wei Wilson / Johari, Yazmin / Burton, Paul R / Earnest, Arul / Shaw, Kalai / Hare, James L / Brown, Wendy A

Obesity surgery

2020 Volume 30, Issue 8, Page(s) 2863–2869

Abstract: Purpose: Obesity and cardiac failure are globally endemic and increasingly intersecting. Bariatric surgery may improve cardiac function and act as a bridge-to-transplantation. We aim to identify effects of bariatric surgery on severe heart failure ... ...

Abstract	Purpose: Obesity and cardiac failure are globally endemic and increasingly intersecting. Bariatric surgery may improve cardiac function and act as a bridge-to-transplantation. We aim to identify effects of bariatric surgery on severe heart failure patients and ascertain its role regarding cardiac transplantation. Materials and methods: A retrospective study of a prospectively collected database identified heart failure patients who underwent bariatric surgery between 1 January 2008 and 31 December 2017. Patients were followed up 12 months post-operatively. Cardiac investigations, functional capacity, cardiac transplant candidacy, morbidity and length of stay were recorded. Results: Twenty-one patients (15 males, 6 females), mean age 48.7 ± 10, BMI 46.2 kg/m Conclusion: Bariatric surgery is safe and highly effective in obese patients with severe heart failure with substantial improvements in cardiac function and symptoms. A threshold pre-operative BMI of 49 kg/m
MeSH term(s)	Adult ; Bariatric Surgery ; Body Mass Index ; Female ; Gastrectomy ; Heart Failure/complications ; Heart Failure/surgery ; Humans ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Retrospective Studies ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left
Language	English
Publishing date	2020-04-29
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/s11695-020-04612-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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