Postoperative values of vitamin D show a progressive increase, while PTH ones present a significant reduction, without any impact on serum calcium levels. We have demonstrated an inverse correlation between weight loss and vitamin D increase at the third month after surgery.

Bariatric surgery has been shown to be effective in achieving and maintaining weight change and reducing obesity-related comorbidities. Recent reports have shown that sleeve gastrectomy could have similar resolution rates of the metabolic syndrome than Roux-Y bypass after a short-term follow-up of 1 year. Most surgeons calibrate the sleeve with 32-Fr to 40-Fr bougies. There is little mid- and long-term information available about the evolution of these comorbidities with this procedure and with calibration of the sleeve with a 50-Fr bougie. A retrospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy, calibrated with a 50-Fr bougie, as bariatric procedure between October 2007 and September 2009 was performed. Mean excessive body mass index loss was 76.9 per cent after 1 year and 79.9 per cent after 2 years. After surgery, 83.3 per cent of patients with Type 2 diabetes mellitus discontinued their hypoglycemic medication at 1 month. All the patients with hypertension discontinued antihypertensive drugs at 6 months. One hundred per cent of patients with hypertriglyceridemia discontinued their hypolipidemic drugs at 3 months. Glucose levels decreased significantly 3 months after surgery (mean reduction of 24.7 mg/dL; 95% confidence interval [CI], 8.8 to 40.7; P = 0.003). Triglyceride levels decreased 3 months after surgery (mean reduction of 54.4 mg/dL; 95% CI, 22.8 to 86.1; P = 0.004). High-density lipoprotein (HDL) cholesterol increased significantly after 12 months (increase of 16.7 mg/dL; 95% CI, 11.7 to 21.7; P < 0.001). The changes observed were maintained 24 months after surgery. Sleeve gastrectomy, calibrated with a 50-Fr bougie, significantly reduced glucose and triglyceride levels and the cardiovascular risk predictor triglyceride/HDL ratio and increased HDL levels after surgery and maintained them under normal ranges for at least 2 years.

Umbilical hernia is a high-prevalence problem in adults. Traditional herniorrhaphy is marked by high recurrence rates, but nowadays, the use of prosthetic materials has improved results and has even brought about lower morbidity rates, making the enterocutaneous fistula an exceptional complication of umbilical hernioplasty. We report on a case of a 54-year-old male who developed a high-debt enterocutaneous fistula 1 year after undergoing an operation for an umbilical hernia by means of a plug-technique hernioplasty. We discuss the case, treatment, and preventable aspects of this complication.

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