bluuebunny/crossref_metadata_2025_split huggingface dataset:
IBC Oxford University Oral Abstract 5 - The role of fundoplication sleeve gastrectomy in obesity surgery: a systematic review and meta-analysis
Authors: Lopes D Fernado , Dias A Silva , Amorim-Cruz F , Bouça-Machado R , Resende F , Costa-Pinho A , Preto J , Carneiro S , da Costa E Lima , Pinto B Sousa , Sousa H Santos 
Published: February 2025

Abstract

Introduction
Fundoplication Sleeve Gastrectomy (FSG) is a new bariatric procedure that was proposed as an alternative to the standard sleeve gastrectomy (SG), which is associated with an increase in the incidence and prevalence of gastroesophageal reflux disease (GERD). This systematic review and meta-analysis aimed to assess the current evidence on this new surgical procedure in terms of weight loss, prevalence of GERD after the bariatric procedure and postoperative complications.

Methods
Following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations, we conducted a systematic review and meta-analysis by searching three databases (PubMed, Scopus, and Web of Science). We performed a meta- analysis of relative risks to compare FSG and SG for postoperative prevalence of GERD and postoperative complications. Heterogeneity was assessed using I2 statistic.

Results
Fourteen articles were included in the qualitative synthesis and 3 in the quantitative synthesis (meta-analysis). Weight loss was assessed through percentage of excess weight loss (%EWL) in 9 studies from the qualitative synthesis and %EWL at 12 months follow-up ranged between 58 ± 23% and 83.3 ± 28.5%. The comparison between FSG and SG showed no statistically significant difference (RR = 0.36; 95%c.i. [0.13; 1.03]; P = 0.056) regarding postoperative prevalence of GERD. However, a trend indicating a lower risk of postoperative GERD after FSG was observed. Regarding postoperative complications, there was no significant difference between the two approaches (RR = 1.53; 95%c.i. [0.67; 3.49]; P = 0.314).

Conclusion
Our systematic review and meta-analysis reported encouraging results concerning weight loss, GERD symptoms after surgery and postoperative complications after FSG, however, current evidence is still limited. Additional standardized studies, comparing FSG to other bariatric procedures and directly comparing different types of FSG are needed.
IBC Oxford University Oral Abstract 6 - Definition and predictors of insufficient weight loss after bariatric surgery: a retrospective cohort study
Authors: Cruz F Amorim , Sousa H Santos , Nogueiro J , Vaz S , Vieira Sousa J P , Lemos J , Peleteiro B , Resende F , Pinho A Costa , Preto J , Freitas P , Carneiro S , da Costa E Lima 
Published: February 2025

Abstract

Introduction
After bariatric surgery, insufficient weight loss (IWL)—a failure to achieve sufficient weight loss—is the main reason for undergoing a second revisional bariatric surgery. Not only is a standardized definition for IWL missing, but its pre-, peri, and postoperative predictor factors remain unclear. This study aims to assess rates of IWL two years after bariatric surgery, applying 4 definitions; and identify predictors of IWL to improve patient counselling regarding their prevention and optimize intraoperative bariatric procedures.

Methods
We conducted a single-centre retrospective cohort study with 1056 consecutive patients submitted to bariatric surgery between 2019 and 2021. Regarding IWL, the following four definitions were applied: (1) body mass index (BMI) higher than 35 kg/m2 at 24 months; (2) percentage of excess weight loss (%EWL) of less than 50% at 18 months; (3) percentage of total weight loss (%TWL) of less than 20% at 24 months; (4) percentage of alterable weight loss (%AWL) of less than 35% at 24 months. All participants were followed for at least 2 years. Univariate and multivariate analyses were performed using logistic regression to compute the odds ratio (OR) and the 95% confidence intervals (95%c.i.).

Results
A total of 1056 patients were included, with a mean age of 45.8 (±10.3) years, of which 82.9% were female. Significant insufficient weight loss rates ranged from 6 to 14% depending on the definition, being the %EWL the definition with the highest proportion of patients with IWL. Considering %TWL as the definition for IWL, patients with IWL had significantly longer hospital time response (adjusted odds ratio: 1.03, 95% c.i.: 1.02–1.05) and were more submitted to sleeve gastrectomy (adjusted odds ratio: 2.51, 95% c.i.: 1.46–4.30). Male gender was associated with IWL only considering the first definition (BMI &gt; 35 kg/m2) (adjusted odds ratio: 3.55, 95% c.i.: 2.36–5.33) and the second definition (%EWL) (adjusted odds ratio: 4.43, 95% c.i.: 2.80–7.02). The multivariate analysis showed that a longer hospital response and sleeve gastrectomy were independent predictors of IWL after bariatric surgery, regardless of the definition.

Conclusion
The predictors of insufficient weight loss varied depending on the definition applied. However, regardless of the IWL’s definition, a longer hospital response and sleeve gastrectomy were independent predictors of insufficient weight loss after bariatric surgery.
IBC Oxford University Oral Abstract 9 - Reversal of SADI bypass to normal anatomy
Authors: Andraos Y , Andraos M 
Published: February 2025

Abstract

Background
Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) or with Gastric Sleeve Plication (SADI-GSP) are technically highly demanding hypo-absorbtive bariatric procedures generally indicated in high BMI patients (&gt;50 kg/m2) with or without a metabolic syndrome. Data from the literature prove the procedure to be safe and effective. However, hypoproteinemia is a major concern as a severe long-term complication that may need re-operation to elongate the common loop or to reverse it to normal anatomy.

Methods
Among 1,204 patients who underwent bariatric procedures at our institution from May 3rd 2016 till February 14th 2024, 303 patients underwent SADI-S or SADI-GSP as primary procedure, or revisional procedure after sleeve gastrectomy, or gastric sleeve plication (GSP). Early and late post-operative nutritional complications were analysed. Albumin level under normal value at one year was noticed in 21 patients (6.9%).

Results
Hypoalbuminemia was corrected in 8 patients (38.09%) using medical management, parenteral nutrition and IV albumin. 13 others were re-operated at 5 years. 6 of them were reversed to normal anatomy (The common loop length was initially performed at 2.5 m from the ileocaecal junction and at 3 m from the ileocaecal junction in 2 cases.) One patient among the 6 presented with peritonitis on day 2 without evidence of anastomotic leak (second look, washing, and drainage were performed along with antibiotics). 7 patients underwent lengthening of the common loop. The choice of technique was guided by local anatomical changes (adhesions, bleeding, and tension), the surgeon’s conviction, and the patient’s preference. Both techniques achieve normal level of albumin at 3 months.

Conclusion
Our data, coherently with the literature, confirms that SADI-S and SADI-GSP are safe and effective procedures with acceptable complications rate. The hypoproteinemia rate was related to lack of data about gastric sleeve capacity and common loop length. Currently, 3.5 m is the adopted length at our institution with wide sleeve gastrectomy. More data is needed to draw definitive conclusions.
IBC Oxford University Oral Abstract 13 - Video abstract: fistula treatment after bariatric surgery with partially covered metallic stent -laparoscopic removal
Authors: Falcão M , Neto M Galvao , de Jesus R Nascimento , Bastos F , Ramos J Renata Faria , Quadros L Gustavo , Grecco E , Felicio J Henrique , Marques L 
Published: February 2025

Abstract
Case Presentation
The patient underwent Roux in Y Gastric Bypass by laparoscopy without complications, developing on postoperative day 7 with an abscess in the epigastrium at the site of the 5 mm portal, associated with local pain, fever and chills. Within 24 hours, there was spontaneous drainage of large amounts of purulent secretion, with pain improvement. The patient was advised to be hospitalized again and started on broad-spectrum antibiotic therapy.
Abdominal CT and Upper GI endoscopy were performed, which revealed leakage from the gastro-enteric anastomosis with spontaneous cutaneous drainage without compromising the cavity. The patient remained with a WallFlexTM Oesophageal 23 mm stent for 34 days, with complete remission of the infectious condition. Endoscopic removal attempts of the stent were unsuccessful due to adherence by pseudo-polyptic adhesions that fixed the uncovered area of the stent extremities, preventing endoscopic detachment and consequent removal.
We chose to perform laparoscopic access through the alimentary loop immediately below the gastro-enteric anastomosis was performed with an enterotomy with identification of the stent at its distal end, The stent was released and exteriorised to the proximal portion with laparoscopic section of the pseudo-polyps at the proximal end that fixed the Stent. We were able to free the proximal end by removing the stent without additional injuries via the enterotomy. Enterorrhaphy and cavity drainage were performed.
The patient was discharged on postoperative day 3 progressing clinically well and under endoscopic control after 9 months with maintained surgical anatomy and satisfactory surgery results.
IBC Oxford University Oral Abstract 14 - Video abstract: a rare case of lower gastric pouch necrosis post Roux-en-Y gastric bypass with leak and severe sepsis
Authors: Bhambri A , Mehra N 
Published: February 2025

Abstract
Case Presentation
A 40-year-old gentleman with a weight of 120 kgs (BMI 45 kg/m2) underwent a laparoscopic Roux-en-Y gastric bypass at another centre. He was discharged on postoperative day 2 but had complaints of respiratory distress and an elevated heart rate but no contrast enhanced CT abdomen was done. The patient was discharged but his clinical status deteriorated on postoperative Day 3.
A contrast enhanced CT (CECT) abdomen showed gross pneumo-peritoneum and a leak from the gastro-jejunal anastomosis on postoperative Day 4. The patient presented to our unit on postoperative day 4 with gasping, tachycardia (155/min), tachypnoea (48/min), the arterial blood gas (ABG) showed severe metabolic acidosis with pH of 7.0. The patient was anuric and was severely dehydrated as no IV fluids or antibiotics were given at the previous tertiary hospital) The patient was resuscitated for 5 hours and taken for surgery after consent including the risk of death.
The operative findings were a septic peritoneal cavity with a gush of air on entering the abdomen The lower and medial parts of the gastric pouch were completely necrotic and sloughed off. A gastro-jejunal anastomosis leak was confirmed by an intra-operative air insufflation test. The gastric tissue was very friable. The anastomotic sutures were loose and so four interrupted sutures were taken, and the leak site was repaired. A post-gastro-jejunal anastomosis repair air insufflation test showed no leak. A feeding gastrostomy was placed and secured to the gastric remnant for post-operative feeding Thorough peritoneal toilet was performed and multiple abdominal drains were placed.
The patient had a stormy recovery post-operatively with associated metabolic acidosis and tachycardia and was intubated for 48 hours. After extubation, she was pyrexial and made slow progress. She was discharged on postoperative day 14 with her feeding gastrostomy removed after 4 weeks once patient was tolerating adequate oral intake
IBC Oxford University Oral Abstract 20 - Video abstract: dysphagia and malnutrition post LINX procedure for GERD
Authors: Damrah O , Amaireh W K 
Published: February 2025

Abstract

Introduction
The LINX (Magnetic sphincter augmentation) is an option for gastrooesophageal reflux disease (GERD) which has serious complications including severe dysphagia and malnutrition.

Methods
A 27-year-old male patient with long standing GERD failing to respond to PPI medication and lifestyle changes, He underwent a laparoscopic hiatal hernia repair with Toupet fundoplication but failed to respond with ongoing reflux.
An Upper GI endoscopy revealed recurrence of a hiatal hernia with Grade B reflux esophagitis. He then underwent redo-hiatal hernia repair with LINX placement which was complicated by severe dysphagia with weight loss (BMI 20 kg/m2). Following this removal of the LINX device and conversion to Roux-en-Y gastric bypass was done.

Result
The patient recovered with improvement of his reflux and dysphagia symptoms and re-gained weight (BMI 25.3 kg/m2).

Conclusion
Removal of the LINX device and Roux-en-Y gastric bypass is a viable and the preferred option for severe dysphagia and malnutrition post LINX placement.
IBC Oxford University Oral Abstract 22 - Esophagogastric cancer surgery characteristics and outcomes in bariatric patients, compared with non-bariatric patients
Authors: Lessing Y , Abu-Abeid A , Falk E , Lahat G , Nizri E , Dayan D 
Published: February 2025

Abstract

Background
The association between bariatric surgery and esophagogastric cancer (EGC) is debated. This study aimed to assess EGC characteristics and surgery outcomes comparing bariatric and non-bariatric patients.

Methods
Single-centre retrospective analysis of prospective EGC surgery database.

Results
EGC-surgery was performed in 269 patients, classified as bariatric (n = 10, 3.3%), and non-bariatric (n = 259, 96.6%) groups. Non-bariatric group was sub-classified into body mass index (BMI) &lt;35 kg/m2 (n = 244) and &gt;35 kg/m2 (n = 15). BMI was 35.3 ± 5.6 versus 25.7 ± 16.1 and 37.8 ± 8.7 kg/m2 in bariatric versus non-bariatric-BMI &lt;35 and &gt;35, respectively (P &lt; 0.001). Bariatric patients were significantly younger (56.75 ± 11 versus 71 ± 10 and 68.38 ± 8.2 years; P &lt; 0.001). They tended to have lower rates of diabetes mellitus (30% versus 43.9% and 73.3%; P = 0.05) and significantly lower hypertension rates (50%, versus 86.5% and 93.3%, P &lt; 0.004). Bariatric procedures were performed 11.3 years (IQR 5.5–16.5) prior to EGC-surgery. Tumour characteristics were statistically comparable except a significantly higher number of positive LN in the bariatric group (6.9 ± 13.6 versus 2.7 ± 4.9 and 1.9 ± 4.8;P = 0.006), and more bariatric patients received adjuvant treatment (P = 0.035). Postoperative major complication rates (0% versus 25.8%, and 33.3%; P = 0.14) and length of hospital stay (14.1 ± 15.3, versus 23 ± 28.5, and 21 ± 18 days; P = 0.59) were comparable. There was no significant difference in Disease- free survival (P = 0.42) or overall survival (P = 0.48) between patient-groups.

Conclusions
Bariatric patients were diagnosed with EGC at a younger age and tended to have worse nodal involvement. Although outcomes were comparable, clinical and endoscopic surveillance seem important as EGC can occur 10 years or earlier than in non-bariatric patients.
IBC Oxford University Oral Abstract 25 - Laparoscopic delivery of a novel enterotomy capture device between self-forming magnetic anastomosis in Roux-en-Y gastric bypass (RYGB) patients for the creation of a side-side jejunal-jejunal anastomosis
Authors: Contreras J E , Marín P , Guerra A , Mellafe M E , Darvich Í 
Published: February 2025

Abstract

Background
In previously bi-partition studies, a magnetic anastomosis has demonstrated the ability to reduce anastomosis complications such as leaks and bleeding, however previous delivery methods required the creation an enterotomy with delayed anastomosis creation. We report the procedure feasibility and 30-day results of a first ever use in humans of a novel surgical technique that eliminates the need to close the enterotomies via conventional methods after creating the anastomosis and facilitates an immediate lumen opening between two new coupled self-forming magnets (SFM) in RYGB patients.

Methods
Prospective non-randomized single centre trial. Surgery consisted in creating an immediate communication in a side-to-side jejunal-jejunal anastomosis intraluminally through a novel temporary enterotomy control and capture (ECC) device. All devices were deployed and delivered laparoscopically.

Results
A total of 5 patients were recruited, with a mean age of 35.8 (27–43) years, sex-ratio (60% F) and initial BMI of 44.8 ± 7.6 kg/m2. All procedures were performed laparoscopically. There was no conversion or peri-operative mortality. All ECCs and SFMs were delivered and connected with no delivery malfunctions, completed in an anastomosis creation time of 10 minutes (enterotomy to magnet coupling). All ECC and SFMs passed with no retentions. A total of 1 procedure adverse events (AE) occurred due to poor tolerance to oral intake from gastro-jejunal anastomosis inflammation. 0 AE occurred during the 30-day follow up period.

Conclusions
Preliminary and procedure feasibility data of these new surgical techniques and devices suggest the procedures are both feasible and safe in RYGB surgery. Further and longer studies are warranted.
IBC Oxford University Oral Abstract 28 - Assessment of rivaroxaban as VTE prophylaxis after gastric bypass surgery
Authors: Mohamed E 
Published: February 2025

Abstract

Background
Bariatric surgery is increasingly utilized to manage and prevent health issues related to obesity and the associated high incidence of venous thromboembolism (VTE). This work aimed to evaluate the effectiveness of a prophylactic dose of rivaroxaban against the development of VTE after bariatric surgery.

Methods
This prospective cohort study was carried out on 40 morbid obese patients aged 18–60 years old, both sexes, with body mass index (BMI) ≥40 or &gt;35 kg/m2 with obesity-related co-morbidities who underwent gastric bypass surgery. Patients received rivaroxaban 10 mg once a day orally 24 h post-operation for 1 month.

Results
After 30 days, thrombosis did not occur in any patient. Intra luminal bleeding occurred in 3(7.5%) of the patients who were presented with melena, tachycardia, and hypotension and readmitted and all managed conservatively. The mean red blood cells transfused was 2.7 units, plasma transfused was 3.3 units, and the mean hospital stay was 2.3 days.

Conclusions
Prophylactic oral rivaroxaban 10 mg once daily 24 h after gastric bypass surgery for 1 month is effective against VTE development.
IBC Oxford University Oral Abstract 34 - Ursodeoxycholic acid prophylaxis and the reduction of gallstone formation after bariatric surgery: an updated meta-analysis of randomized controlled trials
Authors: Alhuniti M 
Published: February 2025

Abstract

Introduction
Gallstone formation following bariatric surgery poses a significant clinical concern, prompting various preventive strategies, including ursodeoxycholic acid (UDCA) prophylaxis. This systematic review and meta-analysis aimed to assess the efficacy of UDCA in preventing gallstone formation after bariatric surgery.

Methods
A comprehensive literature search was conducted in major databases up to September 2023, identifying 12 randomized controlled trials (RCTs) meeting the inclusion criteria. The studies, spanning from 1993 to 2022, involved 2767 patients who underwent diverse bariatric procedures. The primary outcome was the overall incidence of cholelithiasis, with secondary outcomes encompassing gallstone occurrences at three, six, and 12 months; symptomatic cholelithiasis; and rates of cholecystectomy. The Cochrane risk-of-bias tool was utilized for evaluating study quality, and statistical analyses were conducted using the RevMan software (Cochrane Collaboration, London, UK).

Results
Patients receiving UDCA demonstrated a significantly lower overall incidence of gallstones post-bariatric surgery (risk ratio [RR] 0.13; P &lt; 0.0001). Subgroup analyses confirmed reduced gallstone incidence at three months (P = 0.04), six months (P &lt; 0.00001), and one year (P &lt; 0.00001) with UDCA prophylaxis. Symptomatic cholelithiasis incidence was also lower in the UDCA group (RR 5.70; P &lt; 0.00001), and cholecystectomy rates were significantly reduced (RR 3.05; P = 0.002).

Conclusions
This meta-analysis supports the efficacy of UDCA prophylaxis in preventing gallstone formation after bariatric surgery. The findings suggest that UDCA administration not only lowers overall gallstone incidence but also reduces the occurrence of symptomatic cholelithiasis and mitigates the need for cholecystectomy. However, caution is warranted due to heterogeneity, diverse surgical procedures, and limited long-term follow-up in the included studies. Further research with standardized protocols and extended observational periods is recommended to strengthen the evidence base and guide clinical practice.
IBC Oxford University Poster Abstract 18 - Roux-en-Y gastric bypass distalisation for insufficient weight loss or weight regain: a systematic review and meta-analysis
Authors: Dias A Silva , Amorim-Cruz F , Fernandes Lope D , Bouça-Machado R , Resende F , Preto J , Carneiro S , da-Costa E Lima , Sousa-Pinto B , Santos-Sousa H 
Published: February 2025

Abstract

Background
Weight Regain or Insufficient Weight Loss after primary Roux-en-Y Gastric Bypass (RYGB) poses a significant challenge for bariatric surgeons. Distalisation of RYGB serves as a revisional malabsorptive procedure, potentially offering a solution, albeit with associated complications. This review and meta-analysis aim to enhance the evidence base concerning the safety and efficacy of several distalisation variants.

Methods
Following PRISMA recommendations, we conducted a systematic review and meta-analysis across three databases (PubMed, Scopus, and Web of Science). Primary outcomes included short-term (1 year), mid-term (2–3 years), and long-term (5 years) weight loss progress. Secondary outcomes encompassed early postoperative complications, comorbidity resolution, hypoalbuminemia, Protein Energy Malnutrition (PEM), and the need for surgical revision. Subgroup analyses categorized patients based on Total Alimentary Limb Length (TALL) and Common Limb (CL) lengths, as well as by the type of Distalisation performed.

Results
Our analysis comprised 18 studies. Across all studies, %Excess Weight Loss (%EWL) was 59.4% (short-term), 58.6% (mid-term), and 67.5% (long-term). Subgroup analysis revealed that TALL &lt;325 cm correlated with improved weight loss but increased PEM risk compared to TALL ≥325 cm. Similarly, CL &lt;125 cm was associated with higher complication rates than CL ≥125 cm. Type I surgery yielded superior weight loss compared to Type III at short and mid-term. High heterogeneity was noted among results.

Conclusions
A TALL above 325–350 cm and a CL above 125–150 cm seem to offer a potentially safer approach, while maintaining favourable weight loss outcomes. Type I distalisation demonstrated the most promising weight loss pattern. Enhanced standardization in surgical practice and terminology is imperative for comprehensive evaluation of distalisation outcomes.