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    Bridged mini gastric bypass: a novel metabolic and bariatric operation
    (Mary Ann Liebert, Inc, 2019) Sümer, Aziz; Atasoy, Deniz; Barbaros, Umut; Savaş, Osman Anıl; Eren, Eryiğit; Yurdaışık, Işıl; Mercan, Selçuk
    Introduction: In this article, we aimed to report the first five cases of laparoscopic bridged mini gastric bypass (BMGB) in the treatment of obesity and type II diabetes mellitus (DM). Presentation of Cases: We have performed five cases with a new modified surgical method that we call a BMGB. The patients' recoveries were uneventful. The weight losses of the patients were 15, 13, 14, 11, and 13 kg subsequently and with complete normalization of all metabolic parameters at first month of follow-up. Discussion: The BMGB was modified from the mini gastric bypass and resulted with the same nutritional results, less surgical complications, and a possible advantage of remaining access to the remnant stomach. Conclusion: BMGB may be as effective and possibly an even easier operation to treat obesity and uncontrolled type II DM with possible advantages over currently available metabolic procedures.
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    Experience of the endoscopists matters in endoscopic retrograde cholangiopancreatography in billroth II gastrectomy patients
    (Korean Soc Gastrointestinal Endoscopy, 2020) Çağlar, Erkan; Atasoy, Deniz; Tozlu, Mukaddes; Altınkaya, Engin; Doğan, Serkan; Şentürk, Hakan
    Background/Aims: Altered anatomy is a challenge in endoscopic retrograde cholangiopancreatography (ERCP) for patients with Billroth II anastomosis. In this study, we investigated the overall success and role of endoscopist experience. Methods: Data of patients who underwent ERCP between 2014 and 2018 after a previous Billroth II operation were retrieved retrospectively from 2 tertiary FRCP centers. The procedures were performed by 2 endoscopists with different levels of experience. Clinical success was defined as extraction of the stone, placement of a stent through a malignant stricture, and clinical and laboratory improvements in patients. Results: Seventy-five patients were included. The technical success rate was 83% for the experienced endoscopist and 75% for the inexperienced endoscopist (p=0.46). The mean (istandard deviation) procedure tune was 23.8 +/- 5.7 min for the experienced endoscopist and 40.684:6.07 min for the inexperienced endoscopist (p<0.00I). In total, 3 perforations (4%) were found. 'the rate of afferent loop perforation was 6.25% (1/16) for the inexperienced endoscopist and 0% (0/59) for the experienced endoscopist (p=0.053). Conclusions: FRCP in patients who had undergone Billroth II gastrectomy was time consuming for the inexperienced endoscopist who should beware of the unique adverse events related to ERCP in patients with altered anatomy.