Bypass gástrico
Gastric bypass
Ismael Díez del Val1
, Cándido Martínez-Blázquez, Juan Valencia-Cortejoso, Valentín Sierra-Esteban, José María Vitores-López
Autor para correspondencia
idiez@htxa.osakidetza.net
Correspondencia: Dr. I. Díez del Val. Sección de Cirugía Gastroesofágica y Endocrina. Unidad de Cirugía Bariátrica. Servicio de Cirugía General. Hospital Txagorritxu. José Achótegui, s/n. 01009 Vitoria-Gasteiz. Álava. España.
Correspondencia: Dr. I. Díez del Val. Sección de Cirugía Gastroesofágica y Endocrina. Unidad de Cirugía Bariátrica. Servicio de Cirugía General. Hospital Txagorritxu. José Achótegui, s/n. 01009 Vitoria-Gasteiz. Álava. España.
Sección de Cirugía Gastroesofágica y Endocrina. Unidad de Cirugía Bariátrica. Servicio de Cirugía General. Hospital Txagorritxu. Vitoria-Gasteiz. Álava. España
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Unidad de Cirugía Bariátrica. Servicio de Cirugía General. Hospital Txagorritxu. Vitoria-Gasteiz. Álava. España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Dr. I. Díez del Val. Sección de Cirugía Gastroesofágica y Endocrina. Unidad de Cirugía Bariátrica. Servicio de Cirugía General. Hospital Txagorritxu. José Achótegui, s/n. 01009 Vitoria-Gasteiz. Álava. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gastric bypass" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec199017" "palabras" => array:3 [ 0 => "Obesidad mórbida" 1 => "Bypass gástrico" 2 => "Bypass gástrico por laparoscopia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec199018" "palabras" => array:3 [ 0 => "Morbid obesity" 1 => "Roux-en-Y gastric bypass" 2 => "Laparoscopic Roux-en-Y gastric bypass" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Resumen</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Entre las técnicas quirúrgicas para el tratamiento de la obesidad mórbida, el bypass gástrico es en la actualidad el realizado con más asiduidad. Entre febrero de 1998 y octubre de 2003 en nuestro servicio hemos llevado a cabo 454 bypass gástricos, 408 primarios y 46 como conversión de gastroplastia anillada previa: 274 por vía abierta y 180 por laparoscopia. La edad media de los pacientes fue de 41 años (19- 68) y un 83% de éstos eran mujeres. El peso medio fue de 132 kg (75-220) y el índice de masa corporal, de 48,23 kg/m2 (37-71).</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">De los 233 pacientes intervenidos de forma primaria mediante cirugía abierta, 24 (10,3%) sufrieron complicaciones, destacando 3 dehiscencias (1,3%), 13 hemorragias (5,6%) y un fallecimiento (0,43%). Ocho tuvieron que ser reintervenidos. De los 175 bypass gástricos primarios por laparoscopia, 12 pacientes (6,9%) experimentaron, entre otras, 4 dehiscencias (2,3%), 6 hemorragias (3,4%), 5 reoperaciones y un fallecimiento (0,57%).</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A largo plazo, destacan un 28% de eventraciones en cirugía abierta y 3 hernias transmesocólicas en cirugía laparoscópica, que nos han hecho cambiar el ascenso del asa de Roux a la vía antecólica y antegástrica. El 79% de los 56 pacientes seguidos durante más de 4 años alcanza un índice de masa corporal inferior a 35 kg/m2, y el 85% mantiene un sobrepeso perdido superior al 50%. El porcentaje medio del sobrepeso perdido es del 71%.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Of the surgical techniques for the treatment of morbid obesity, gastric bypass (GB) is currently the most widely performed.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Between February 1998 and October 2003, in our service we performed 454 GB, 408 primary and 46 as conversion from previous ringed gastroplasty: 274 procedures were performed using open surgery and 180 were performed using the laparoscopic approach. The mean age of the patients was 41 years (19- 68) and 83% were women. The mean weight was 132 kg (75-220) and the mean body mass index (BMI) was 48.23 kg/m2 (37-71).</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Of the 233 patients who underwent primary open surgery, 24 (10.3%) presented complications, notably three dehiscences (1.3%), 13 hemorrhages (5.6%) and one death (0.43%). Eight patients required reoperation. Of the 175 primary laparoscopic GB, 12 patients (6.9%) presented complications. Among others, these complications consisted of four dehiscences (2.3%), six hemorrhages (3.4%), five reoperations and one death (0.57%).</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The most important long-term complications were eventrations in 28% of patients undergoing open surgery and transmesocolic hernias in three patients undergoing laparoscopic surgery, which led us to change limb placement to antecolic-antegastric. Of the 56 patients followed-up for more than 4 years, 79% achieved a BMI of less than 35 kg/m2 and 85% maintained a weight loss of more than 50%. The mean percentage of excess weight lost was 71%.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:46 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "IBSR, IBSR 2000-2001 Winter Pooled Report" ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "paginaInicial" => "19" "serieFecha" => "2001" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "ASBS and SAGES. 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Ikramuddin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Clin N Am" "fecha" => "2001" "volumen" => "81" "paginaInicial" => "1145" "paginaFinal" => "1179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11589250" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0230" "etiqueta" => "46." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgery for morbid obesity (Cochrane Review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Colquitt" 1 => "A. Clegg" 2 => "M. Sidhu" 3 => "P. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 6 | 14 | 20 |
| 2024 Septiembre | 29 | 20 | 49 |
| 2024 Agosto | 22 | 27 | 49 |
| 2024 Julio | 36 | 27 | 63 |
| 2024 Junio | 33 | 28 | 61 |
| 2024 Mayo | 23 | 30 | 53 |
| 2024 Abril | 30 | 36 | 66 |
| 2024 Marzo | 42 | 59 | 101 |
| 2024 Febrero | 39 | 19 | 58 |
| 2024 Enero | 24 | 30 | 54 |
| 2023 Diciembre | 42 | 52 | 94 |
| 2023 Noviembre | 46 | 40 | 86 |
| 2023 Octubre | 46 | 24 | 70 |
| 2023 Septiembre | 23 | 16 | 39 |
| 2023 Agosto | 52 | 25 | 77 |
| 2023 Julio | 51 | 76 | 127 |
| 2023 Junio | 45 | 18 | 63 |
| 2023 Mayo | 51 | 11 | 62 |
| 2023 Abril | 33 | 10 | 43 |
| 2023 Marzo | 30 | 23 | 53 |
| 2023 Febrero | 36 | 26 | 62 |
| 2023 Enero | 11 | 18 | 29 |
| 2022 Diciembre | 21 | 28 | 49 |
| 2022 Noviembre | 90 | 41 | 131 |
| 2022 Octubre | 63 | 25 | 88 |
| 2022 Septiembre | 52 | 37 | 89 |
| 2022 Agosto | 55 | 29 | 84 |
| 2022 Julio | 44 | 15 | 59 |
| 2022 Junio | 29 | 16 | 45 |
| 2022 Mayo | 33 | 15 | 48 |
| 2022 Abril | 30 | 25 | 55 |
| 2022 Marzo | 53 | 27 | 80 |
| 2022 Febrero | 22 | 21 | 43 |
| 2022 Enero | 46 | 23 | 69 |
| 2021 Diciembre | 49 | 30 | 79 |
| 2021 Noviembre | 41 | 36 | 77 |
| 2021 Octubre | 38 | 29 | 67 |
| 2021 Septiembre | 21 | 37 | 58 |
| 2021 Agosto | 11 | 10 | 21 |
| 2021 Julio | 26 | 14 | 40 |
| 2021 Junio | 31 | 26 | 57 |
| 2021 Mayo | 28 | 16 | 44 |
| 2021 Abril | 61 | 18 | 79 |
| 2021 Marzo | 46 | 32 | 78 |
| 2021 Febrero | 45 | 32 | 77 |
| 2021 Enero | 34 | 34 | 68 |
| 2020 Diciembre | 31 | 34 | 65 |
| 2020 Noviembre | 41 | 55 | 96 |
| 2020 Octubre | 35 | 35 | 70 |
| 2020 Septiembre | 47 | 28 | 75 |
| 2020 Agosto | 49 | 26 | 75 |
| 2020 Julio | 23 | 29 | 52 |
| 2020 Junio | 9 | 37 | 46 |
| 2020 Mayo | 36 | 30 | 66 |
| 2020 Abril | 30 | 29 | 59 |
| 2020 Marzo | 33 | 58 | 91 |
| 2020 Febrero | 26 | 41 | 67 |
| 2020 Enero | 28 | 42 | 70 |
| 2019 Diciembre | 82 | 59 | 141 |
| 2019 Noviembre | 28 | 63 | 91 |
| 2019 Octubre | 27 | 74 | 101 |
| 2019 Septiembre | 85 | 72 | 157 |
| 2019 Agosto | 29 | 93 | 122 |
| 2019 Julio | 39 | 122 | 161 |
| 2019 Junio | 92 | 138 | 230 |
| 2019 Mayo | 232 | 259 | 491 |
| 2019 Abril | 89 | 186 | 275 |
| 2019 Marzo | 23 | 138 | 161 |
| 2019 Febrero | 41 | 143 | 184 |
| 2019 Enero | 25 | 133 | 158 |
| 2018 Diciembre | 21 | 74 | 95 |
| 2018 Noviembre | 43 | 155 | 198 |
| 2018 Octubre | 66 | 46 | 112 |
| 2018 Septiembre | 15 | 50 | 65 |
| 2018 Agosto | 16 | 175 | 191 |
| 2018 Julio | 10 | 168 | 178 |
| 2018 Junio | 12 | 143 | 155 |
| 2018 Mayo | 19 | 156 | 175 |
| 2018 Abril | 12 | 122 | 134 |
| 2018 Marzo | 5 | 109 | 114 |
| 2018 Febrero | 4 | 113 | 117 |
| 2018 Enero | 2 | 81 | 83 |
| 2017 Diciembre | 8 | 65 | 73 |
| 2017 Noviembre | 7 | 123 | 130 |
| 2017 Octubre | 6 | 72 | 78 |
| 2017 Septiembre | 5 | 86 | 91 |
| 2017 Agosto | 9 | 90 | 99 |
| 2017 Julio | 10 | 95 | 105 |
| 2017 Junio | 13 | 128 | 141 |
| 2017 Mayo | 15 | 144 | 159 |
| 2017 Abril | 16 | 95 | 111 |
| 2017 Marzo | 18 | 163 | 181 |
| 2017 Febrero | 23 | 154 | 177 |
| 2017 Enero | 9 | 54 | 63 |
| 2016 Diciembre | 22 | 67 | 89 |
| 2016 Noviembre | 50 | 130 | 180 |
| 2016 Octubre | 68 | 114 | 182 |
| 2016 Septiembre | 19 | 114 | 133 |
| 2016 Agosto | 21 | 62 | 83 |
| 2016 Julio | 39 | 20 | 59 |
| 2016 Junio | 52 | 107 | 159 |
| 2016 Mayo | 60 | 107 | 167 |
| 2016 Abril | 51 | 123 | 174 |
| 2016 Marzo | 57 | 97 | 154 |
| 2016 Febrero | 45 | 79 | 124 |
| 2016 Enero | 44 | 66 | 110 |
| 2015 Diciembre | 40 | 47 | 87 |
| 2015 Noviembre | 51 | 44 | 95 |
| 2015 Octubre | 50 | 28 | 78 |
| 2015 Septiembre | 28 | 22 | 50 |
| 2015 Agosto | 61 | 14 | 75 |
| 2015 Julio | 58 | 10 | 68 |
| 2015 Junio | 49 | 11 | 60 |
| 2015 Mayo | 33 | 8 | 41 |
| 2015 Abril | 29 | 10 | 39 |
| 2015 Marzo | 32 | 8 | 40 |
| 2015 Febrero | 18 | 3 | 21 |
| 2015 Enero | 56 | 5 | 61 |
| 2014 Diciembre | 69 | 6 | 75 |
| 2014 Noviembre | 67 | 3 | 70 |
| 2014 Octubre | 70 | 3 | 73 |
| 2014 Septiembre | 65 | 2 | 67 |
| 2014 Agosto | 32 | 3 | 35 |
| 2014 Julio | 45 | 4 | 49 |
| 2014 Junio | 54 | 3 | 57 |
| 2014 Mayo | 38 | 1 | 39 |
| 2014 Abril | 33 | 2 | 35 |
| 2014 Marzo | 34 | 3 | 37 |
| 2014 Febrero | 27 | 3 | 30 |
| 2014 Enero | 31 | 3 | 34 |
| 2013 Diciembre | 36 | 4 | 40 |
| 2013 Noviembre | 58 | 3 | 61 |
| 2013 Octubre | 44 | 5 | 49 |
| 2013 Septiembre | 45 | 8 | 53 |
| 2013 Agosto | 25 | 6 | 31 |
| 2013 Julio | 6 | 2 | 8 |
| 2004 Abril | 1527 | 0 | 1527 |
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