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A Protocol for Roux-en-Y Gastric Bypass in Rats using Linear Staplers
Published on: August 21, 2021
Gastric bypass after liver transplantation
Abdl-Rawf Al-Nowaylati1, Benjamin J S Al-Haddad, Rob B Dorman
1Division of Gastrointestinal and Bariatric Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN.
Summary
Bariatric surgery after liver transplant shows weight loss and improved diabetes control. However, Roux-en-Y gastric bypass (RYGB) may increase risks, including death, in some post-orthotopic liver transplantation (OLT) patients.
Area of Science:
- Hepatology
- Bariatric Surgery
- Transplantation Medicine
Background:
- Limited data exist on bariatric surgery outcomes post-orthotopic liver transplantation (OLT).
- Assessing the safety and efficacy of Roux-en-Y gastric bypass (RYGB) in OLT recipients is crucial.
Purpose of the Study:
- To evaluate the outcomes of RYGB in patients who previously underwent OLT.
- To analyze weight changes, comorbidity management, and potential complications.
Main Methods:
- Retrospective review of a bariatric surgery database and transplant registry (2001-2009).
- Inclusion of 7 patients who underwent OLT followed by open RYGB.
- Collection of data on BMI, laboratory values, comorbidities, and immunosuppression.
Main Results:
- Mean follow-up was 59 months post-RYGB; mean time between OLT and RYGB was 27 months.
- Significant BMI reduction from 44.3 to 26.5 kg/m² post-RYGB.
- Improved glycemic control in type 2 diabetes mellitus (T2DM) patients; improved HDL levels.
- Two deaths occurred (multiple-organ dysfunction, metastatic cancer); one RYGB reversal due to malnutrition.
- RYGB may have contributed to one death.
Conclusions:
- RYGB in OLT patients can achieve therapeutic weight loss and improve T2DM control.
- Potential risks include malnutrition, death, and complications possibly related to RYGB.
- Further research is needed to establish optimal patient selection and management strategies.
