Evolution of type 2 diabetes mellitus in non morbid obese gastrectomized patients with Roux en-Y reconstruction: Retrospective study

Objective Bariatric surgery in morbidly obese patients with type 2 diabetes results systematically in adequate glycemic control, normalization of insulinemia, and a decrease in glycosylated hemoglobin, effects that appear early after surgery in nearly 80 to 90% of them. Possible reasons that have been discussed are a decrease in caloric consumption, weight loss, and hormonal changes at the gastrointestinal level, which could have a positive effect on glucose metabolism. Various authors have proposed the possibility of passing on this indication to diabetic patients who are overweight or are mildly obese. The purpose of this retrospective investigation was to determine the effect of total or subtotal gastrectomy with Roux-en-Y reconstruction on the metabolic control of patients with type 2 diabetes with a body mass index (BMI)<35, operated on for reasons other than obesity. Methods From January 1999 to December 2007, a total of 23 diabetic patients who underwent total or subtotal gastr

Gastrointestinal stromal tumors. Review of 15 patients

Artículo de publicación ISIBackground Gastrointestinal stromal tumors (GIST) are the most common mesenchymatous tumors of the digestive tract. The pathological diagnosis is based on microscopy and immunohistochemistry. Aim To review the experience of our surgical unit in patients with GIST. Material and methods: Review of medical records of 15 patients (aged 66 +/- 13 years, 11 women), with a pathological diagnosis of GIST, treated between 1999 and 2005. Results: The main presenting symptoms were melena in 40% hematemesis in 20%, abdominal pain in 60% and anemia in 13%. In only one patient, the tumor appeared as an incidentaloma. All patients underwent upper gastrointestinal endoscopy. A CAT scan was done in 87%, a barium swallow in 60% and a digestive endosonography in 20%. Thirteen tumors were located in the stomach and two in the small bowel. Mean, tumor diameter was 5.3 +/- 1.7 cm. Surgical management was a tumor resection in 40% a partial gastrectomy in 27%, a total gastrectomy in 20% and an intestinal excision in the rest. Mean hospital stay was 6.9 +/- 4.2 days. No postoperative complications were recorded. Conclusions: The main clinical presentation of GIST in this retrospective series was an upper gastrointestinal bleeding. Surgical treatment was devoid of complications (Rev Med Chile 2007, 135 551-7)

Outcomes of normothermic machine perfusion of liver grafts in repeat liver transplantation (NAPLES initiative).

BACKGROUND Retransplantation candidates are disadvantaged owing to lack of good-quality liver grafts. Strategies that can facilitate transplantation of suboptimal grafts into retransplant candidates require investigation. The aim was to determine whether late liver retransplantation can be performed safely with suboptimal grafts, following normothermic machine perfusion. METHODS A prospectively enrolled group of patients who required liver retransplantation received a suboptimal graft preserved via normothermic machine perfusion. This group was compared with both historical and contemporaneous cohorts of patient who received grafts preserved by cold storage. The primary outcome was 6-month graft and patient survival. RESULTS The normothermic machine perfusion group comprised 26 patients. The historical (cold storage 1) and contemporaneous (cold storage 2) groups comprised 31 and 25 patients respectively. The 6-month graft survival rate did not differ between groups (cold storage 1, 27 of 31, cold storage 2, 22 of 25; normothermic machine perfusion, 22 of 26; P = 0.934). This was despite the normothermic machine perfusion group having significantly more steatotic grafts (8 of 31, 7 of 25, and 14 of 26 respectively; P = 0.006) and grafts previously declined by at least one other transplant centre (5 of 31, 9 of 25, and 21 of 26; P < 0.001). CONCLUSION In liver retransplantation, normothermic machine perfusion can safely expand graft options without compromising short-term outcomes

Recommendations for the management of pancreatic cancer type adenocarcinoma. A consensus statement reached during the 2015 Latin American Symposium on Gastroenterological Oncology

Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Vina del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin Americ