Bariatric Surgery mortality has been reduced to 0.3% in recent years

closing of Congress with great success of participation SEEDO X

– gastric bypass surgery has proved to be one of the most effective techniques, with a 75% weight loss success

-closing conference, in charge of one of the world specialists in the study of diabetes, addressed the factors in the occurrence of fatty liver

Barcelona, 2011-October the surgery of obesity is a complex surgery, not free of complications, whose aim is not to achieve an ideal weight or cure obesity, but reduce the associated Comorbidities and improve the quality of life of patients, according to experts who spoke at the Symposium treatment failure in bariatric surgery management ”, which was held last Friday.

In recent years, mortality in this type of intervention has been reduced almost altogether, as explained by Dr. Carles Masdevall the Bellvitge Hospital (Barcelona) have spent a few years ago to accept a mortality rate of 2 per cent have a rate of 0.3 per cent today, thanks to the improvement of surgical techniques like laparoscopy and the experience of surgeons ”.

So far, bariatric surgery is the only treatment that can improve the expectations in the long term (> 5 years) in patients with morbid obesity, but these patients must meet certain requirements to ensure success.

But as warned Dr. Amador Garcia, specialist of the unit of digestive surgery of the Hospital Universitari de Bellvitge not forget that the surgery of obesity is not without complications or side effects that may curtail significantly the quality of life of patients, and that the intervention can lead to a failure ”.

Considered that an intervention has failed when beyond the 2 years the patient kept a BMI greater than 30 kg/m2 or weight loss is less than 50%. Can say that the surgery has failed when it fails a proper weight loss, or when after a correct weight loss, there is a significant reganancia of the weight lost. In these cases, must be revision surgery ”, continued Dr. García.

The experts determined that despite the fact that in recent years has made significant progress in improving techniques Bariatric must be aware of the need to educate patients to maintain food behavior and healthy habits of life, to ensure long-term success.
Currently, the most commonly used techniques are becoming increasingly less invasive which allows to reduce postoperative pain and speed recovery, as for example the gastric bypass surgery that is performed by laparoscopy.

As explained by Dr. Cándido Martínez, the Txagorritxu Hospital, Vitoria, the gastric bypass has proved to be one of the most effective techniques in the treatment of the obese morbid, with a 75% weight loss success ”.

In addition, in the case of the super obese is designed a bypass to correct malabsorption in line with your body mass index that has shown efficacy in all cases, with the loss of 50% of its weight.

Revision surgery Bariatric (CRB) is required for a patient operated previously obesity surgery for failure of the technique due to a number of causes, such as the bad choice of procedure or non-compliance with the patient for medical indications before and after the operation.

For that reason, revision surgery is not straightforward and is generally taxed at a higher than primary surgery complications rate. In addition, the chances of success are also lower than with a primary procedure.

Another of the problems of obesity surgery is called hypoglycemia, a complication that arises in some patients undergoing gastric surgery within a few months or even years after surgery. Between 20-30% of patients have gastrointestinal problems; but between 1-6% of patients operated on with gastric bypass suffer symptoms neuroglucopénicos, and 0.3% have severe neuroglucopenia, although these cases are very infrequent.

Thus described it DRA. Nuria Vilarrasa, University Hospital of Bellvitge, which explained the different treatments that currently exist for this pathology. dietary treatment is based on a diet low in carbohydrates that improve symptoms in 83 per cent of cases and also proved the pharmacological treatment with acarboseantagonists of calcium or somatostatin. As a last option and in the event that do not work the other two, can be a surgical treatment, such as surgeries aimed at restoring the gastric restriction or restoration of gastrointestinal transit ”.

As a final conclusion, Dr. Masdevall stressed the need for this type of intervention by very expert surgeons to ensure the greatest possible success.

New approach to the causes and diagnosis of fatty liver

The closing conference was in charge of the DRA. Hanneke Iky-Järvinen from the University of Helsinki (Finland), who spoke of new findings in the diagnosis and pathogenesis of fatty liver not due to the consumption of alcohol.

Between 5% and 10% of the population has fatty liver not associated with the consumption of alcohol and the degree of obesity, but with genetic and environmental factors which predetermine an increased risk of type 2 diabetes and cardiovascular disease.

In the case of genetic factors, a total of 16 independent studies carried out since 2008 and performed in different ethnic groups, found how a mutation in the gene PNPLA3 is directly associated to an increase in fatty liver but not to the insulin resistance as he was initially believed ”, according to the doctor. He also noted that fatty liver disease responds very quickly before a speech in the diet and weight reduction.

The prohibition of excessive consumption of simple sugars may be an important factor of reduction of fatty liver. In fact, in a study that administered a diet high in simple sugars (1000 calories a week extra) participants showed an increase of 27% in the rates of fatty liver in just three weeks.

SEEDO, twenty years working on obesity

The Spanish society for the study of obesity is an entity created 20 years ago with the goal of being a meeting point for all professionals – clinical and basic – related obesity. Currently, account with more than 350 partners, coming from different areas of health, mainly of Endocrinology and, despite his brief career, has emerged as a partner of reference for the Administration and other scientific societies, a multidisciplinary forum for meeting of experts, and a platform to encourage the education citizen in this field

the significant increase in the number of partners that has been the society, the number of attendees at the Conference and, above all, the scientific papers presented at this Congress, reveal the rapid progress of the SEEDO, from different perspectives dealing with a disease that has become a public health problem and one of the leading causes of morbidity and mortality in Spain.