Biomedical subjects

G B Starkloff

Publications and source records attributed to G B Starkloff.

3 recordsLinked to original sources

PubMed1978

Intestinal bypass: a modification.

Six hundred sixty-four patients who have had metabolic intestinal surgery for the treatment of morbid obesity are reviewed. Particular attention is directed to difference in weight loss, morbidity and mortality in end-to-side and end-to-end shunts, the former performed in 300 patients and the latter in 262 patients. Unsatisfactory weight loss was observed in 20% of patients with end-to-side shunts, while only 8% of patients with end-to-end shunts failed to lose a sufficient amount of weight. Morbidity and mortality were significantly increased in this latter group. This led to adoption of a modification of the end-to-side operation by developing a plication ?REVENT REFLUX. Our preliminary observation indicates that in 102 patients who have had this operation, similar weight loss is attained to that of end-to-end shunts with no greater morbidity or mortality than the end-to-side type.

Humans↗

PubMed1977

Jejunal intussusception following small bowel bypass for morbid obesity.

In 600 patients who have undergone small bowel bypass for the treatment of morbid obesity, we have encountered three patients who developed intussusception in the bypassed intestine. Diagnosis in these cases has been difficult but in two patients with surgical marker clips applied to the transected fixed jejunum as well as to the adjacent mesocolon, diagnosis was made easier by the radiographic finding of separation of these clips. Clinical symptoms are difficult to evaluate and valuable time may be wasted before a diagnosis is arrived at. Once a diagnosis is made, operation with either reduction or resection of the area of intussusception should be carried out with refixation of the bowel to the mesocolon and reapplication of surgical marker clips. These marker clips are of great value in the diagnosis of intussusception occurring in the bypassed loop.

Adult↗

PubMed1975

Metabolic intestinal surgery. Its complications and management.

From November 1970 to August 1974 small intestinal bypass was performed in 475 patients for morbid obesity with an operative mortality of 1.6%. Immediate postoperative complications were superficial wound infection (17 patients), pulmonary complications (seven patients), cardiac complications (five patients), wound dehiscence (nine patients), intestinal tract fistula (four patients), and miscellaneous complications (14 patients). Delayed complications included hypokalemia (28%), hypocalcemia (9%), anemia (11%), calcium oxalate urinary calculi (6%), gout (2%), and hepatic failure (1.4%). Fourteen patients died of late complications. Ventral incisional hernia occurred in 3% of the patients; failure to lose sufficient weight in 21%, all but one occurring in patients with end-to-side shunts. Thirteen end-to-side shunts have been converted to end-to-end shunts because of insufficient weight loss. A team concept is important in the handling of the morbidly obese. Small bowel bypass is effective in producing sustained weight reduction in these patients. Careful and continued study of these patients for the rest of their lives is of paramount importance.

Anemia↗