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Biomedical subjects

J H Linner

Publications and source records attributed to J H Linner.

9 recordsLinked to original sources
PubMed1995

A multicenter, placebo-controlled, randomized, double-blind, prospective trial of prophylactic ursodiol for the prevention of gallstone formation following gastric-bypass-induced rapid weight loss.

BACKGROUND: Previous studies have documented a high incidence of gallstone formation following gastric-bypass (GBP)-induced rapid weight loss in morbidly obese patients. This study was designed to determine if a 6-month regimen of prophylactic ursodiol might prevent the development of gallstones. METHODS: A multicenter, randomized, double-blind, prospective trial evaluated 3 oral doses of ursodiol: 300, 600, and 1,200 mg versus placebo beginning within 10 days after surgery and continuing for 6 months or until gallstone development, for patients with a body mass index (BMI) > or = 40 kg/m2. All patients had normal intraoperative gallbladder sonography. Transabdominal sonography was obtained at 2, 4, and 6 months following surgery, or until gallstone formation. RESULTS: Of 233 patients with at least one postoperative sonogram, 56 were randomized to placebo, 53 to 300 mg ursodiol, 61 to 600 mg ursodiol, and 63 to 1,200 mg ursodiol. Preoperative age, sex, race, weight, BMI, and postoperative weight loss were not significantly different between groups. Gallstone formation occurred at 6 months in 32%, 13%, 2%, and 6% of the patients on the respective doses. Gallstones were significantly (P < 0.001) less frequent with ursodiol 600 and 1,200 mg than with placebo. CONCLUSION: A daily dose of 600 mg ursodiol is effective prophylaxis for gallstone formation following GBP-induced rapid weight loss.

Adolescent↗
PubMed1992

Reoperative surgery--indications, efficacy, and long-term follow-up.

The Roux-en-Y gastric bypass with fascial support (RYGBPF) has proved to be effective as a primary as well as a revision/conversion operation in the management of morbid obesity. Since May 1984, 361 primary and 100 revision RYGBPF operations have been reported with low morbidity and mortality although morbidity and mortality were higher in the revision than in the primary group. The most common late complications of gastric-reduction operations resulting in weight regain were staple line disruption and pouch or stoma enlargement. With the use of the RYGBPF as a primary as well as a revision operation, weight loss results at 5 y have been good and our revision operation rate has dropped to less than 1%.

Follow-Up Studies↗
PubMed1982

Comparative effectiveness of gastric bypass and gastroplasty: a clinical study.

Gastric bypass (GBP; 227 cases) was compared with gastroplasty (GP; 189 cases) with a follow-up of six months to four years. After two years, mean weight loss of patients with GBP was 43.4 kg (34.2% of preoperative weight and 63.5% of excess weight loss), with a 5.7% failure rate. Corresponding results for those receiving GP were 27 kg (22.1% and 44.7 %), with a failure rate of 42.5%. The revision rate for GP (11.1%) was twice that for GBP (4.3%). There were two GBP and five GP perforations. There were two deaths among the 416 patients (0.48%), both in the GBP group. Gastric bypass was found to be more effective with fewer revisions than gastroplasty, but the mortality was higher. Roux-en-Y GBP is our current choice for surgical treatment of morbid obesity.

Adult↗