Browsing by Author "Ibanez, Luis"

Now showing 1 - 13 of 13
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    11 beta-Hydroxysteroid Dehydrogenase Type 1 is Overexpressed in Subcutaneous Adipose Tissue of Morbidly Obese Patients
    (SPRINGER, 2009) Munoz, Rodrigo; Carvajal, Cristian; Escalona, Alex; Boza, Camilo; Perez, Gustavo; Ibanez, Luis; Fardella, Carlos
    11 beta-Hydroxysteroid dehydrogenase type 1 (11 beta-HSD1) enzyme catalyzes interconversion of inactive cortisone to active cortisol. Its expression in adipose tissue has been associated with obesity and some of its metabolic disorders. Controversies regarding which fat depots [subcutaneous adipose tissue (SAT) or visceral adipose tissue (VAT)] have higher expression still remain. The aim of this work was to evaluate 11 beta-HSD1 expression in SAT and VAT of obese patients and evaluate its association to metabolic features of metabolic syndrome.
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    Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study
    (2007) Escalona, Alex; Devaud, Nicolas; Perez, Gustavo; Crovari, Fernando; Boza, Carnilo; Viviani, Paola; Ibanez, Luis; Guzman, Sergio
    Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has become the most common surgical treatment for morbid obesity. Intestinal obstruction and internal hernias are cornplications more commonly observed after LRYGB than after open RYGB. The aim of this study was to evaluate the incidence of these cornplications in patients who had undergone LRYGB using an antecolic versus a retrocolic technique.
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    Gallbladder polyps
    (2006) Escalona, Alex; Leon, Francisca; Bellolio, Felipe; Pimentel, Fernando; Guajardo, Matias; Gennero, Ruben; Cruz, Juan Pablo; Viviani, Paola; Ibanez, Luis
    Background: Gallbladder polyps are becoming a common finding. The management of these polyps is complicated considering that they can bear malignant lesions. Aim: To analyze the ultrasonographic and histopatbologic findings of patients operated due to gallbladder polyps. Patients and methods: The records of patients with ultrasonograpbic diagnosis of gallbladder polyp and that underwent cholecystectomy in a thirteen years period were reviewed, collecting their demographic, ultrasonograpbic and histopathological data. Results: One hundred and twenty three patients were operated. Tbe mean age was 44 +/- 13 years, and 69% were women. The mean size of polyps in ultrasonography was 7.3 +/- 5 mm. Histopathology confirmed the presence of polyps in 79% of patients, with a mean size and number of lesions of 5.1 +/- 3.8 mm and 2.1 +/- 2, respectively. Nine percent of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p = 0.003). Four cases of adenoma (3.2%) were diagnosed; one of them had in situ carcinoma. All were single and larger than 10 mm. We found a significant correlation between ultrasonograpbic and histopathological polyp size determination (r = 0.47; p = 0.002). Polyp size was also a predictor of the presence of adenoma (p = 0.043; confidence intervals., 1.006-1.424). Conclusions: There is a good correlation between the size of the gallbladder polyp in ultrasonography and the size in the histopathology report. Gallbladder adenoma is uncommon and it correlates with the size of the polyp. In this series, size was the only predictor of the presence of adenoma.
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    GALLBLADDER POLYPS: CORRELATION AND AGREEMENT BETWEEN ULTRASONOGRAPHIC AND HISTOPATHOLOGICAL FINDINGS IN A POPULATION WITH HIGH INCIDENCE OF GALLBLADDER CANCER
    (2023) Inzunza, Martin; Irarrazaval, Maria Jesus; Pozo, Paloma; Pimentel, Fernando; Crovari, Fernando; Ibanez, Luis
    BACKGROUND: Gallbladder polyps are becoming a common finding in ultrasound. The management has to consider the potential risk of malignant lesions. AIMS: The aim of this study was to analyze the ultrasound findings in patients undergoing cholecystectomy due to gallbladder polyps and compare them for histopathological findings (HPs). METHODS: Patients with an ultrasonographic diagnosis of gallbladder polyp and who underwent cholecystectomy from 2007 to 2020 were included in the study. RESULTS: A total of 447 patients were included, of whom 58% were women. The mean age was 45 +/- 12 years. The mean size of polyps in US was 7.9 +/- 3.6 mm. Notably, 9% of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p=0.003). Histopathological findings confirmed the presence of polyps in 88.4%, with a mean size of 4.8 +/- 3.4 mm. In all, 16 cases were neoplastic polyps (4.1%), 4 of them being malignancies, and all were single and larger than 10 mm. We found a significant correlation between ultrasound and histopathological findings polyp size determination (r=0.44; p<0.001). The Bland-Altman analysis obtained an overestimation of the US size of 3.26 mm. The receiver operating characteristic (ROC) curve analysis between both measures obtained an area under the receiver operating characteristic curve (AUC) of 0.77 (95%CI 0.74-0.81). Ultrasound polyps size larger than 10 mm had an odds ratio (OR) of 8.147 (95%CI 2.56-23.40) for the presence of adenoma and malignancy, with a likelihood ratio of 2.78. CONCLUSIONS: There is a positive correlation and appropriate diagnostic accuracy between ultrasound size of gallbladder polyps compared to histopathological records, with a trend to overestimate the size by about 3 mm. Neoplastic polyps are uncommon, and it correlates with size. Polyps larger than 10 mm were associated with adenoma and malignancy.
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    Importance of Routine Preoperative Upper GI Endoscopy: Why All Patients Should Be Evaluated?
    (2009) Munoz, Rodrigo; Ibanez, Luis; Salinas, Jose; Escalona, Alex; Perez, Gustavo; Pimentel, Fernando; Guzman, Sergio; Boza, Camilo
    Morbid obesity is associated with different gastrointestinal alterations and diseases. Surgically induced weight loss has become the best treatment for morbidly obese patients. Roux-en-Y gastric bypass is the most common procedure performed worldwide. Concerns regarding difficulties in further evaluation of stomach remnant for early detection of gastric cancer, however, have emphasized the routine use of preoperative upper endoscopy, even in asymptomatic patients, to detect upper gastrointestinal abnormalities. The main outcome of this study was to identify the most common preoperative endoscopic findings.
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    INTESTINAL PERFORATION SECONDARY TO BLUNT INGUINAL TRAUMA IN A SOCCER PLAYER: A CASE REPORT
    (ELSEVIER SCIENCE INC, 2012) Vucetich, Nevenka; Andresen, Max; Hasbun, Pablo; Regueira, Tomas; Ibanez, Luis; Gonzalez, Alejandro
    Background: Intestinal perforation caused by blunt trauma to an inguinal hernia is a very uncommon event. Case Report: We present the case of a 55-year old man who suffered trauma to the inguinal area while playing soccer and later developed intense abdominal pain with no categorical signs of peritoneal irritation. Computed tomography scan at arrival showed a right inguinal hernia, with partial protrusion of the ileum, inflammatory changes of the mesenteric fat tissue inside the hernial sac, and free intraperitoneal fluid. Several hours later he developed hypotension and fever. An emergency laparotomy was performed, revealing ileum perforation with peritonitis. Intestinal perforation was repaired without intestinal resection. After surgery, the patient developed severe septic shock with multiple organ failure. He recovered without sequelae and was discharged 3 weeks later. Conclusion: This case emphasizes the potential clinical complications associated with this condition. (C) 2012 Elsevier Inc.
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    Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding: five years of follow-up
    (ELSEVIER SCIENCE INC, 2010) Boza, Camilo; Gamboa, Cristian; Awruch, Diego; Perez, Gustavo; Escalona, Alex; Ibanez, Luis
    Background: Bariatric surgery is an effective treatment for morbid obesity Laparoscopic Rouxen-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are commonly performed procedures The aim of the present study was to evaluate and compare the lone-term outcomes after LRYGB and LAGB
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    Laparoscopic Sleeve Gastrectomy as a Stand-Alone Procedure for Morbid Obesity: Report of 1,000 Cases and 3-Year Follow-Up
    (SPRINGER, 2012) Boza, Camilo; Salinas, Jose; Salgado, Napoleon; Perez, Gustavo; Raddatz, Alejandro; Funke, Ricardo; Pimentel, Fernando; Ibanez, Luis
    Laparoscopic sleeve gastrectomy (LSG) is an emerging surgical technique with encouraging results. The objective of this study is to report surgical results after 1,000 consecutive LSG cases as a stand-alone procedure for morbid obesity during a 3-year follow-up.
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    Routine preoperative ultrasonography and selective cholecystectomy in laparoscopic Roux-en-Y gastric bypass.: Why not?
    (2008) Escalona, Alex; Boza, Camilo; Munoz, Rodrigo; Perez, Gustavo; Rayo, Sabina; Crovari, Fernando; Ibanez, Luis; Guzman, Sergio
    Background Preoperative evaluation and treatment of biliary lithiasis in morbid obese patients who are candidates to bariatric surgery raise a series of questions which to date has no clear consensus. The aim of this study was to evaluate the results of routine preoperative abdominal ultrasonography and selective cholecystectomy comparing patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGBP) with and without simultaneous cholecystectomy.
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    Safety and Efficacy of Roux-en-Y Gastric Bypass to Treat Type 2 Diabetes Mellitus in Non-severely Obese Patients
    (2011) Boza, Camilo; Munoz, Rodrigo; Salinas, Jose; Gamboa, Cristian; Klaassen, Julieta; Escalona, Alex; Perez, Gustavo; Ibanez, Luis; Guzman, Sergio
    The efficacy of Roux-en-Y gastric bypass (RYGB) to control type 2 diabetes mellitus (T2DM) has been demonstrated in morbidly obese patients. Surgical procedures primarily focused on T2DM control in patients with body mass index (BMI) < 35 kg/m(2) have shown to effectively induce remission of T2DM. However, only few reports have evaluated the safety and efficacy of RYGB in this group of patients. The aim of this study is to assess the safety and efficacy of RYGB in TD2M patients with BMI < 35 kg/m(2). All T2DM patients with BMI < 35 kg/m(2) and at least 12 months of follow-up who underwent laparoscopic RYGB were included. Safety of the procedure was evaluated according to mortality, need of reoperation/conversion, and complication rates. Metabolic parameters were evaluated at baseline and 6, 12, and 24 months after surgery. Thirty patients were included. Seventeen (56.6%) were women. Age, BMI, and duration of diabetes were 48 +/- 9 years, 33.7 +/- 1.2 kg/m(2), 4 +/- 2.9 years, respectively. No mortality was observed. No conversion/reoperation was needed. Average length of stay was 3.2 +/- 0.9 days. Early and late postoperative complications were observed in five (16.6%) and five (16.6%) patients, respectively. Twelve months after surgery, remission was observed in 25 of 30 patients (83.3%). After 2 years, remission was achieved in 13 of 20 patients (65%), and hemoglobin A1c decreased from 8.1 +/- 1.8% to 5.9 +/- 1.1% and homeostasis model assessment of insulin resistance from 5.7 +/- 3.2 to 1.9 +/- 0.8 after 12 months. RYGB is a safe and effective procedure to induce T2DM remission in otherwise not eligible patients for bariatric surgery. Evidence from prospective studies is needed to validate this approach.
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    Serial analysis of gene expression identifies connective tissue growth factor expression as a prognostic biomarker in gallbladder cancer
    (AMER ASSOC CANCER RESEARCH, 2008) Alvarez, Hector; Corvalan, Alejandro; Roa, Juan C.; Argani, Pedram; Murillo, Francisco; Edwards, Jennifer; Beaty, Robert; Feldmann, Georg; Hong, Seung Mo; Mullendore, Michael; Roa, Ivan; Ibanez, Luis; Pimente, Fernando; Diaz, Alfonso; Riggins, Gregory J.; Maitra, Anirban
    Background: Gallbladder cancer (GBC) is an uncommon neoplasm in the United States, but one with high mortality rates. This malignancy remains largely understudied at the molecular level such that few targeted therapies or predictive biomarkers exist.
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    Splenic rupture following colonoscopy
    (BAISHIDENG PUBLISHING GROUP INC, 2008) Francisco Guerra, Juan; San Francisco, Ignacio; Pimentel, Fernando; Ibanez, Luis
    Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy. (C) 2008 The WJG Press. All rights reserved.
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    Weight Loss and Metabolic Improvement in Morbidly Obese Subjects Implanted for 1 Year With an Endoscopic Duodenal-Jejunal Bypass Liner
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Escalona, Alex; Pimentel, Fernando; Sharp, Allan; Becerra, Pablo; Slako, Milenko; Turiel, Dannae; Munoz, Rodrigo; Bambs, Claudia; Guzman, Sergio; Ibanez, Luis; Gersin, Keith
    Objective: To evaluate safety, weight loss, and cardiometabolic changes in obese subjects implanted with the duodenal-jejunal bypass liner (DJBL) for 1 year.