Omentopexy/Gastropexy (OP/GP) Following Sleeve Gastrectomy Might be an Effective 2-in-1 Method (Reinforcement and Fixation): A Meta-Analysis of 14 Studies and a Call for Randomized Controlled Trials

A Meta-Analysis Comparing RYGB with Long Biliopancreatic Limb (BPL) Versus Long Alimentary Limb (AL) in Groups with Equal or Nearly Equal Combined Bypass Lengths (Combined BPL and AL Lengths): Does Switching Seats Enhance Weight Loss?

It is well-established that extending either the biliopancreatic limb (BPL), the alimentary limb (AL), or both, results in increased combined bypass (CB) length, which in turn leads to enhanced weight loss and potential nutritional deficiencies due to heightened malabsorptive effects. However, a key question remains: Assuming no change in CB length, does altering BPL length affect outcomes? To address this question, we examined studies comparing long BPL and long AL (short BPL) while maintaining equal or nearly equal CB lengths. We conducted this systematic literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a meta-analysis on weight loss outcomes, adverse events and safety-related outcomes, gastrointestinal complaints, and nutritional outcomes at the 2-year mark.

Antral Preservation in Sleeve Gastrectomy Appears to Protect Against Prolonged Vomiting and Gastroesophageal Reflux Disease. A Meta-Analysis of Randomized Controlled Trials

The optimal distance between the starting point of gastric transection and the pylorus during laparoscopic sleeve gastrectomy (LSG), which can be referred to as the distance from pylorus (DFP), is controversial. No consensus exist for what DFP is considered antral preservation, and what DFP is considered antral resection. Some surgeons prefer shorter DFP to maximize excess weight loss percentage (EWL%), while others prefer longer DFP because they believe that it shortens length of stay (LOS) and protects against leaks, prolonged vomiting, and gastroesophageal reflux disease (GERD). We sought to compare 6-cm DFP and 2-cm DFP in postoperative outcomes. In addition, we sought to evaluate the magnitude of any observed benefit through number needed to treat (NNT) analysis.

Postoperative Stomach Volvulus and Pancreatitis Following a Sleeve Gastrectomy

The laparoscopic sleeve gastrectomy is the most common bariatric surgery performed to promote weight loss and improve obesity-related comorbidities. As the number of patients undergoing sleeve gastrectomy increases, so does the prevalence of complications. It is crucial to recognize both common and unusual complications of sleeve gastrectomy to properly diagnose and manage them. We present a unique case of gastric outlet obstruction not visualized on initial imaging and acute pancreatitis following a sleeve gastrectomy. We recommend performing an endoscopy and ordering serum lipase levels in a patient with negative CT scans but persistent postoperative nausea, vomiting, and abdominal pain. The management of postoperative gastric outlet obstruction includes supportive care, balloon dilation of the stenotic area, or gastric bypass if symptoms persist.