Handbook of Metabolic and Bariatric Surgery

Cover
Title Page
Copyright Page
Contents
List of Contributors
Preface
Part I Introduction to Obesity
Chapter 1 Introduction to Obesity and Obesity-Related Diseases
Obesity and Type 2 Diabetes Mellitus
Obesity and Atherosclerosis
Obesity and Non-Alcoholic Fatty Liver Disease
Obesity and Gallbladder Disease
Obesity and Reproduction
Obesity and Lung Disease
Obesity and Cancer Risk
Obesity and Bio-Mechanical Stress
Case History
Comment
Further Reading
Landmark Studies
Websites
Chapter 2 Diagnosis and Classification of Obesity
Diagnostic Criteria for Obesity
Metabolic Syndrome
Measuring Body Fat
Classification of Obesity
Normal Weight Obese (NWO)
Metabolically Obese Normal Weight (MONW)
Metabolically Healthy Obese (MHO)
Metabolically Unhealthy Obese (MUO)
Further Reading
Chapter 3 The Epidemiology of Obesity
Defining Obesity
The Pathophysiology of Obesity
The Prevalence of Obesity
Further Reading
Chapter 4 Public Health Aspects of Obesity and Related Co-Morbidities
Introduction
Definition of Overweight and Obesity
Obesity – The Size of the Problem
Pathogenesis of Obesity
Genetic Factors
Food Intake Versus Energy Expenditure
Socio-Economic Status
Medications and Medical Conditions
Consequences of Obesity
Health Consequences
Economic Consequences of Obesity and Related Co-Morbidities
Tackling Obesity and Promotion of Weight Loss
Further Reading
Chapter 5 Non-Surgical Management of Obesity
Introduction
Obesity Management from a Patient Perspective
Lifestyle Management of Obesity
Sleep Sufficiency
Mindfulness
Non-Sedentariness
Balanced Diet
Low-Carbohydrate Diet
Low-Fat Diet
Hypocaloric Diet
High-Protein Diet
Formula Diet
Pharmacotherapy for Obesity
Orlistat
Liraglutide
Phentermine–Topiramate Extended Release
Naltrexone SR/Bupropion SR
Lorcaserin
The Challenges of Weight Maintenance
Conclusions and Future Directions
Further Reading
Chapter 6 Organisation of Care for Complex Obesity
Introduction to Complex Obesity Care
Complex Obesity Care
MDT Intervention Programme (Tier 3)
MDT Intervention with Bariatric Surgery (Tier 4)
Complex Obesity Perioperative Care
Complex Obesity Care in End Stage Organ Disease
Complex Obesity Care in Pregnancy
Complex Obesity Care in Childhood
Complex Care in Super-Obesity
Case History
Comment
Further Reading
Chapter 7 The History of Metabolic and Bariatric Surgery
Introduction
Serendipity and the Origin of Metabolic and Bariatric Surgery
Further Reading
Landmark Studies
Suggested Readings
Part II Metabolic and Bariatric Surgery
Chapter 8 Indications and Contraindications of Bariatric and Metabolic Surgery
Introduction
Indications
Contraindications
Further Reading
Chapter 9 Pre-Operative Medical Management
Indications and Contraindications of Bariatric Surgery
Cardiovascular
Cardiac Ischaemia
Atrial Fibrillation
Heart Failure
Hypertension
Valvular Heart Disease
Respiratory
Asthma
Obstructive Sleep Apnoea (OSA)
Gastrointestinal
Endocrine
Diabetes
Venous Thromboembolism Risk
Others
Pre-Operative Medical Weight Management Programme
Case History
Comment
Conclusions
Further Reading
Landmark Studies
Suggested Readings
Chapter 10 Pre-Operative Management of a Bariatric Patient (Nutritional)
Assessment
Education
Regular Meals
Portion Size
Meal Balance
Snacking
Fluid Intake
Dietary Treatment
Very Low Calorie Diets (VLCD)
Low Carbohydrate Diets
Liver-Reducing Diets (LRD)
Commercial Weight-Loss Programmes
Preventing Nutritional Deficiency
Protein
Iron and Calcium
Iron
Calcium
Summary
Case History
Assessment
Discussion
Further Reading
Chapter 11 Pre-Operative Management: Psychological Aspects
Fundamental Psychological Dimensions and Obesity: Behaviour, Emotion and Cognition
Behaviour and Obesity
The Emotions and Obesity
Cognition and Obesity
Living with the Burden of Severe Obesity
Pre-Operative Psychological Assessment
Conclusion
Case History
Comment
Further Reading
Landmark Studies
Websites
Chapter 12 Pre-Operative Management: Anaesthetic
Pre-Operative Assessment Goals
Body Mass Index (Bmi), Phenotypes and Mass
Functional Limitation: Clarifying Cause and Risk
Risk Assessment of Surgical Risks
Further Reading
Chapter 13 Pre-Operative Management: Surgical Considerations
Introduction
Multi-Disciplinary Team Assessment
The Surgical Clinic
Pre-Operative Liver-Reducing Diet
Pre-Operative Expectations
Specialist Bariatric Set-Up
Further Reading
Chapter 14 Mechanism of Action of Bariatric Procedures
Background
The Beginning of Change
Gut Hormones
Bile Acids
Gut Microbiota
Gut–Brain Axis
Epigenetics and Gene Regulation
Conclusion
Further Reading
Chapter 15 Laparoscopic Adjustable Gastric Banding – Technique and Outcomes
History of the Gastric Band
How the Band Works
Indications
Operative Technique
Follow-Up
Outcomes
Common Misconceptions
Gastric Bands Do Not Work
Complications
Further Reading
Chapter 16 Sleeve Gastrectomy
Introduction
Patient Selection
Pre-Operative Preparation
Operative Technique
Complications
Early Complications
Late Complications
Clinical Outcomes
Further Reading
Chapter 17 Roux-en-Y Gastric Bypass
History
Metabolic and Mechanical Mechanisms for Weight Loss
Caloric Restriction
Grehlin
Incretins
Bile Acids
Foregut Hypothesis
Hindgut Hypothesis
Laparoscopic RYGB Technique (Circular, Linear Hand-Sewn and Robotic GJA), Retrocolic Versus Antecolic, Single-Stapled Versus Double-Stapled JJA
Positioning
Trocar Placement
Jejunojejunostomy Creation
Gastric Pouch Creation
Gastrojejunostomy Creation
Leak Test
Pain Management
Differences in Operative Technique
Gastrojejunostomy
Jejunojejunostomy
Antecolic Versus Retrocolic
Closure of Mesenteric Defects
Intraoperative Endoscopy and Post-Operative Contrast Study
Robotic Versus Laparoscopic RYGB
Complications
Marginal Ulcer
Anastomotic Leak
Internal Hernia
Outcomes
Conclusion
Further Reading
Chapter 18 Alternative Bariatric Procedure
Introduction
Biliopancreatic Diversion (BPD)
History
Technique
Outcomes
Complications
Duodenal Switch (BPD-DS or DS)
History
Technique
Outcomes
Complications
Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)
History
Technique
Outcomes
Complications
Duodeno-Jejunal Bypass
History
Technique
Outcomes
Complications
The One Anastomosis Gastric Bypass
History
Technique
Long Gastric Pouch
Outcomes
Complications
Further Reading
Chapter 19 Early Surgical Complications after Metabolic and Bariatric Surgery
Prevention and Management of Leaks in RYGB, SG and One Anastomosis Gastric Bypass (OAGB)
Prevention
Management of Leaks After MBS
Education of the Multi-Disciplinary Team
One Anastomotic Gastric Bypass (OAGB) Is Different Than Roux-en-Y-Gastric Bypass
Sleeve Gastrectomy Leaks
Venous Thromboembolism ‘Errors of Omission’
Obstructive Sleep Apnoea ‘Errors of Detection’
Conclusion
Further Reading
Chapter 20 Post-Operative Management and Follow-Up
Introduction
Enhanced Recovery After Surgery (ERAS)
Early Mobilisation
Incentive Spirometry
Venous Thromboembolism Thromboprophylaxis
Oral Intake
Hospital Discharge and Return to Normal Activities
Follow-Up
Clinical Parameters and the Deteriorating Patient
Early Problems
Late Problems
Further Reading
Part III Outcomes of Metabolic and Bariatric Surgery
Chapter 21 Metabolic Outcomes of Bariatric Surgery
Introduction
Bariatric Surgery and T2D
Bariatric Surgery and NAFLD
Bariatric Surgery and Endocrine Dysfunction
Bariatric Surgery and Lipid Profile
Bariatric Surgery and Hypertension
Conclusions and Future Directions
Case History
Comment
Further Reading
Landmark Studies
Chapter 22 Non-Metabolic Outcomes of Bariatric Surgery
Weight Loss
Cardiovascular
Obstructive Sleep Apnoea
Osteoarthritis and Joint Pains
Lower Back Pain
Urinary Incontinence
Mental Health
Cancer
Reproduction and Fertility
Benign-Intracranial Hypertension
Case History
Comment
Conclusions
Further Reading
Landmark studies
Suggested Readings
Chapter 23 Medical Management of Nutritional Complications
Introduction
Peri-Operative Nutrition
Nutrient Supplementation Post-Bariatric Surgery
Individual Nutritional Deficiencies
Protein Deficiency
Iron
Vitamin B12 (aka Cobalamin)
Ca and Vitamin D
Thiamine
Vitamins A, E and K
Essential Trace Elements
Specific Medical Condition Considerations
Pregnancy
Chronic Kidney or Heart Disease
Gastric Dumping
Case History
Comments
Further Reading
Chapter 24 Metabolic Complications of Bariatric Surgery
Dumping Syndrome
Diagnosis
Treatment
Osteoporosis
Prevention
Diagnosing Osteoporosis
Treatment
Hypothalamic–Pituitary–Adrenal (HPA) Axis
Gonadal Function
Renal Stones
Case History
Comment
Conclusions
Further Reading
Landmark Studies
Suggested Readings
Chapter 25 Long-Term Surgical Complications of Bariatric Surgery
Band-Related Long-Term Surgical Complications
Band Migration/Dysphagia
Band Erosion
Access Port Infection
Gastro-Oesophageal Reflux
Sleeve Gastrectomy-Related Late Surgical Complications
Stricture
Reflux Disease
Leak
Late Complications of Roux-en-Y Gastric Bypass
Marginal Ulcers
Stoma Stenosis
Internal Hernias
Candy Cane Roux Syndrome
One-Anastomosis Gastric Bypass Complications
Gastro-Esophageal Reflux
Stomal Stenosis
Marginal Ulcer
Malabsorptive Complications
Further Reading
Chapter 26 Psychological Considerations Post-Surgery
Disordered Eating and Weight Recurrence
Psychiatric Co-Morbidity
Suicidality
Substance Abuse
Further Reading
Chapter 27 Consideration for Revisional Surgery
Introduction
Indications
Weight
Relapse or Inadequate Control of Co-Morbidities
Procedure Specific
Chronic Complications
Reflux
Reversal
Surgical Revisional Options
Corrective
Gastric Bypass Limb Lengths
Endoscopic Techniques
Conversional
Single Anastomosis Duodenal–Ileal Bypass with Sleeve (SADI)
Adjunctive
Risk and Safety
Medication
Conclusion
Further Reading
Chapter 28 Weight Regain
Introduction
Nutritional Considerations
Regular Meals and Planning (3–6 Small Meals per Day)
Speed of Eating
Overeating
Snacking
Energy Balance
Fluid Intake
Conclusions
Case Discussion
Miss A
Summary
Further Reading
Chapter 29 Patient Perspective
Index
EULA