Upper GI Surgery Flashcards

Question

What are malabsorptive bariatric surgery options?

Answer 1

Malabsorptive operations consist of bypassing segments of bowel, which thereby cause malabsorption of nutrients (such as the biliopancreatic diversion with or without duodenal switch and ileal interposition) In a BPD Biliopancreatic diversion procedure, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the upper part of the small intestines. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the colon. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed.

Answer 2

Involves both aspects of restriction and malabsorption such as the roux - en - Y gastric bypass, considered the gold standard

Answer 3

In a BPD procedure, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the upper part of the small intestines. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the colon. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed.

Answer 4

Advantages: * Relatively minor surgery * Reversible and adjustable * Low operative complication rate * Mortality 0.1% Disadvantages: * Requires an implanted medical device * Easier to ‘cheat’ * Risk of prolapse or slippage * 15% will require revisional surgery

Answer 5

A small stomach pouch is created to restrict food intake. A Y-shaped section of the small intestine is then attached to the pouch to allow food to bypass the lower stomach, the duodenum, and the first portion of the jejunum. Reduces the absorption of nutrients and therefore reduces calorie intake

Answer 6

**•Advantages:** –Quick and dramatic weight loss –Pedigree –Dumping syndrome •**Disadvantages:** –More invasive surgery –Malabsorptive component requires lifelong supplements –More complex if requires revision –Mortality 0.5%

Answer 7

Sleeve gastrectomy is a partial gastrectomy that results in removal of most of the stomach, with the remainder resembling a "banana" or "half moon." The other names for this procedure are "partial gastrectomy,“ "sleeve gastrectomy," "longitudinal gastrectomy“ and "vertical gastrectomy Decreases stomach size - inhibits distension of the stomach so that it becomes fuller sooner, increasing patients sensation of fullness and decreasing appetite

Answer 8

•Advantages: –Good medium term outcomes –No ‘dumping’ syndrome –No small bowel manipulation –No foreign body •Disadvantages: –More invasive surgery –Long staple line (bleeding/leak) –Short pedigree –Mortality 0.4%

Answer 9

A group of symptoms, including weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation, occurring after meals in some patients who have undergone gastric surgery. Happens in laparascopic gstric bypass, but not in laparascopic sleeve gastrectomy

Answer 10

* Anastomotic leak * DVT/PE * Infection * Malnutrition * Vitamin and mineral deficiencies * Hair loss * Excess Skin