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At least 919 records · Page 51Linked to original sources
PubMed1987

Modulation of human upper gastrointestinal motility by rectal distension.

The effects of rectal distension on upper gastrointestinal motility were investigated in six healthy subjects. On a control day, gastric and duodenal motor activity was recorded for nine hours of fasting and for four hours after a meal, duodeno-caecal transit being assessed in both interdigestive and digestive states. Motor activity and transit were also measured on a test day during which the rectum was distended for one hour during fasting and for one hour postprandially. Control and test days were randomised. During fasting, rectal distension increased the incidence of migrating motor complexes (0.8 +/- 0.3 v 0.5 +/- 0.2 h; p less than 0.01) and reduced the duodenal phase 2 motility index to 66 +/- 45% of that observed on the control day (p less than 0.01). Further, duodeno-caecal transit time was increased by rectal distension (99 +/- 30 v 71 +/- 35 min; p less than 0.05). Postprandially, the period of rectal distension was marked by a reduction in the duodenal motility index to 24 +/- 13% of that observed during the comparable period on the control day (p less than 0.001) and a concomitant increase in duodeno-caecal transit time (113 +/- 22 v 80 +/- 17 min; p less than 0.01). We conclude that upper gastrointestinal motor activity, the effector of luminal transit, may be profoundly influenced by stimulation of distal afferents.

Action Potentials↗
PubMed2001

Initial experience with laparoscopic adjustable gastric banding and pouch dilatation: two cases.

BACKGROUND: Late proximal pouch dilatation (LPPD) has occurred occasionally following gastric banding for morbid obesity. At present, laparoscopic conservative resetting and oversuturing of the band is considered the standard procedure for pouch dilatation without any important posterior component. METHODS: Two cases of LPPD are presented, which occurred in our initial experience with the Lap-Band, corrected via a laparoscopic approach. RESULTS: The reintervention was necessary in both patients, with conservative laparoscopic repositioning and oversuturing of the band in the first case and laparoscopic substitution of the gastric band in the second. We have not observed further complications, and weight loss has been maintained in a midterm outcome in both cases (30 and 18 months follow-up). CONCLUSIONS: LPPD can be corrected with a conservative laparoscopic surgical approach, without complications and negative functional effects on mid-term outcome.

Adult↗
PubMed2005

Laparoscopic pouch resizing and redo of gastro-jejunal anastomosis for pouch dilatation following gastric bypass.

BACKGROUND: With a dramatically increasing number of bariatric operations performed world-wide in the recent years, more late complications have been noticed. Proximal gastric pouch dilatation is a known late complication after laparoscopic or open restrictive surgery for morbid obesity. In the present paper, we report our experience with laparoscopic re-operation of enlarged gastric pouches after laparoscopic gastric bypass, with emphasis on technique and outcome. METHODS: Data were retrieved from a prospective database of 334 patients who underwent a laparoscopic gastric bypass operation at the University Hospital of Zurich from July 2000 to December 2004. Five laparoscopic revisions for pouch dilatation after primary bypass were performed. RESULTS: 3 female and 2 male patients with median age 40 years (range 32-55) underwent a laparoscopic pouch resizing. At the time of the re-operation, the median BMI was 32.0 kg/m(2) (range 28.4-48.4). All procedures were performed laparoscopically with no conversion to open surgery. The median operating-time was 110 minutes (95-120). The median hospital stay was 6 days (range 5-14). The median BMI in the follow-up of 12 months (9-14) was 28.0 kg/m(2) (25.5-45.8). Diabetes mellitus improved in 4 cases during follow-up. CONCLUSION: Laparoscopic pouch resizing with redo of the gastro-jejunal anastomosis was feasible, safe and effective in this small series. It led to further weight loss and improved symptoms of poor pouch emptying.

Adult↗
PubMedDate not supplied

A prospective study of survival and recurrence following the acute gastric dilatation-volvulus syndrome in 136 dogs.

Dogs (n = 136) with gastric dilatation-volvulus (GDV) syndrome were followed over time to measure recurrence and mortality rates and to identify prognostic factors. Thirty-three (24.3%) died or were euthanized during the first seven days. Of 85 cases that were followed for up to three years, nine (10.6%) cases each had a recurrence of GDV and seven (8.2%) cases died or were euthanized. The median survival times for cases that had gastropexies and those that did not were 547 and 188 days, respectively. Depressed or comatose cases on admission were three and 36 times, respectively, more likely to die than alert cases, while cases with gastric necrosis were 11 times more likely to die.

Acute Disease↗
PubMed2005

Bile peritonitis associated with gastric dilation-volvulus in a dog.

This report describes a case of septic peritonitis and gall bladder rupture in German shepherd dog that developed 7 d after surgical treatment for gastric dilation-volvulus. Histological examination confirmed gall bladder necrosis, secondary to an acute ischemic event. Postoperative acute necrotizing cholecystitis has not been a previously reported complication in dogs.

Animals↗
PubMed1987

Balloon dilation for the treatment of stomal stenosis complicating gastric surgery for morbid obesity.

In a retrospective analysis, we evaluated our results with endoscopic dilation of enterostomy stenoses that complicated gastric procedures performed for the treatment of morbid obesity. Of 541 patients who underwent a gastric procedure for treatment of morbid obesity, we found 19 patients in whom endoscopic dilations of stenoses had been attempted. We also include three patients who had surgery elsewhere but who underwent dilations at our institution. Fourteen had stenoses complicating gastric bypass with Roux-en-Y anastomoses, and eight had stenoses complicating a gastroplasty (gastrogastrostomy). Two different types of dilation were attempted during the interval reviewed--Fogarty balloon dilations and Grüntzig balloon dilations. None of the eight patients with gastroplasties benefited from the attempted dilation, but 10 of the 14 patients with stenoses complicating gastric bypasses have done well. We found no significant difference between Fogarty and Grüntzig balloon dilations. We conclude that balloon dilation is an effective means of treating stenosis that complicates gastric bypass performed with Roux-en-Y anastomoses in cases of morbid obesity.

Adult↗
PubMed1984

Stomal disruption in gastric partition in morbid obesity (comparison of radiographic and endoscopic diagnosis).

Twenty-two patients who had gastric partition surgery for morbid obesity and subsequently developed stomal dilatation were evaluated with both upper gastrointestinal barium examinations and upper endoscopy. Both examinations were positive in eight patients. Endoscopy alone was positive in 14, but retrospective view of the upper gastrointestinal series was positive in nine of the patients. The authors stress the importance of a dedicated radiologist in performing these difficult examinations and the need for specific measurements of the stomal diameter.

Dilatation, Pathologic↗