Prophylactic Inferior Vena Caval Filters were placed as determine

Prophylactic Inferior Vena Caval Filters were placed as determined to be necessary. The patients were AZD9291 side effects adequately secured on the operating table and were placed supine for the bypass and in Lloyd Davis position for the sleeve and band. A surgical assistant and camera assistant were used in addition to the scrub nurse. All cases were done laparoscopically using a 6-port technique for the gastric bypass and a 5-port technique for the band and sleeve. The gastric bypass was fashioned with a 15�C20cc gastric pouch and a 120�C200cm Roux limb with a 50cm biliopancreatic limb. An antecolic gastrojejunostomy was fashioned using a linear stapler (ETHICON) and this was tested intraoperatively with dye and air. The sleeves were done using the Echelon (ETHICON) stapler using a 38Fr gastric tube and the band used was the Swedish band (ETHICON).

The patients were nursed on the floor (one to one nursing for 12 hours) and ambulated within 4 hours. Low molecular weight heparin was given at this time. The nurses reported directly to the surgeon who was readily available. A very low threshold for return to the operating room was practiced. A routine gastrografin study was done by the surgeon on day 1 prior to starting the liquid diet. The patient was seen in 1 week and then at 6 weeks, 3 months, 6 months, and then yearly with a metabolic screen completed at the yearly visits. Supplements used were chewable multivitamins, calcium, vitamin D, and vitamin B12. 3. Results Two hundred and eighteen patients underwent bariatric surgery during the 8-year study period. Twenty-two patients were lost to followup.

The final analysis consisted of 196 patients; 172 Roux-en-Y gastric bypass, 15 sleeve gastrectomy, and 9 gastric banding. Age ranged from 6 to 68 years (mean 49 years). There was a female preponderance (60%) consistent with the reports of higher prevalence of obesity in this gender in the Caribbean. Preoperative body weight ranged from 79.5�C234.5kg. The BMI ranged from 32�C86kg/m2 (mean 49kg/m2). Comorbidities included hypertension (80%), obstructive sleep apnea (70%), diabetes mellitus (28%), significant back pain (15%), osteoarthritis (13%), polycystic ovarian syndrome (35%), and female infertility (2%). Actual weight lost in the postoperative period ranged from 23.2 to 127.7kg (mean 41.2kg).

Bariatric surgery is usually considered successful if more than 50% of the excess weight is lost postoperatively and maintained at that level. Of the 172 Brefeldin_A patients who underwent gastric bypass, 134 maintained an excess weight loss of greater than 50% (mean 74%) at a mean follow-up time of 3.4 years. Nineteen patients lost less than 50% of the excess weight (mean 39%). Four patients became pregnant (against advice and contraception) within 6 months after surgery and hence never lost significant weight. Fifteen patients lost up to 82% excess weight but regained weight after 1 year.

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