Weight Loss and Vomiting 1 Year After Banded Versus Non-banded One Anastomosis Gastric Bypass: a Prospective Randomized Trial.

BACKGROUND: The weight loss outcomes after banded one-anastomosis gastric bypass (OAGB) remain to be determined. OBJECTIVE: To compare weight loss and vomiting 1 year after banded versus non-banded OAGB. METHODS: This is a prospective, open-label, randomized study, which evaluated 33 individuals with morbid obesity, which underwent banded (16 individuals) and non-banded OAGB (17 individuals) and were followed up for 12 months. Weight loss (percentages of total weight loss-%TWL-and excess weight loss-%EWL) and occurrence of vomiting were assessed and compared before surgery and after 6 and 12 months. RESULTS: At baseline, there were no differences between groups in regard to age, gender, and body mass index (BMI). At 6 and 12 months post-op, and the overall mean %TWL regardless of band use was 22.4 ± 7% and 29 ± 6.9%, respectively, and the overall average %EWL regardless of band use was 66.8 ± 22.9% and 86.3 ± 24%, respectively. %TWL did not differ between the banded and non-banded groups at 6 (21.8 ± 6.8% vs. 23.1 ± 7.4%; p = 0.7) and 12 months post-op (27.5 ± 6.6% vs. 30.4 ± 7.1%; p = 0.3), as well as %EWL at 6 (67 ± 22.9% vs. 67.6 ± 23.6%; p = 0.6) and 12 months post-op (83.5 ± 24.4% vs. 89 ± 24.1%; p = 0.4). The occurrence of vomiting did not significantly differ between banded and non-banded OAGB at 6 (12.5% vs. 11.8%; p = 0.9) and 12 months post-op (12.5% vs. 5.9%; p = 0.5). CONCLUSION: OAGB led to an overall satisfactory weight loss after 1 year, regardless of band use. Banded OAGB did not lead to neither significantly higher weight loss nor more vomiting than non-banded OAGB 1 year after surgery.

Non-Alcoholic Fatty Liver Disease Is Associated with Impairment of Ejection Fraction Among Individuals with Obesity Undergoing Bariatric Surgery: Results of a Cross-Sectional Study.

BACKGROUND: The relationship between non-alcoholic fatty liver disease (NAFLD) and myocardial function seems to be more than just the effect of mutual metabolic risk factors. OBJECTIVE: To determine whether there is a significant association between NAFLD assessed by means of liver biopsy and left ventricular function expressed by the estimated ejection fraction among individuals with obesity. METHODS: This is a cross-sectional study which enrolled individuals who consecutively underwent bariatric surgery. NAFLD was assessed by means of liver biopsies which were systematically collected during the procedures. The estimated ejection fraction was obtained by means of transthoracic echocardiograms. The main outcome evaluated was a possible association between NAFLD features and ejection fraction. The results of liver biopsies and the respective degrees of severity of each NAFLD feature were also correlated with the ejection fraction and main anthropometric, biochemical, and clinical variables. RESULTS: Of 112 individuals, 86.6% were female and the mean age was 38.5 ± 9.3 years. It was observed that the average estimated ejection fraction (EEF) was significantly lower among individuals with liver fibrosis (67.6 ± 5.5% vs. 70.8 ± 4.9%, p = 0.008). After adjustment for confounding variables in a multivariate model, the degree of liver fibrosis was independently associated with the EEF (R = - 0.3, p = 0.02). CONCLUSION: Among individuals with morbid obesity, the findings of this study are suggestive that liver fibrosis confirmed by histopathological examination is associated with a slight impairment of left ventricular function. Further studies are needed to confirm this association.