Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric bypass was used; and in 8 (5%), laparoscopic Roux-en-Y bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.

Introduction: The incidence of obesity is increasing in developed societies, and surgical treatment is one treatment option. The most common surgical treatment for obesity is laparoscopic sleeve gastrectomy (LSG). Gastroesophageal reflux disease (GERD) is a complication of both obesity and the surgical treatment of obesity. Materials and methods: In this study, the PubMed database was searched using the keywords “GERD” and “bariatric surgery”, and 987 papers published between 1 July 2017 and 30 June 2022 were retrieved. Results: Nine papers met the inclusion criteria and were included in the meta-analysis. The articles were analyzed for the de novo occurrence of GERD after the treatment of its symptoms, the occurrence of erosive esophagitis, and Barrett’s esophagus. In addition, interesting conclusions are presented from the papers that did not meet the inclusion criteria but shed light on the pathophysiology of GERD in obese patients undergoing LSG. Conclusion: In conclusion, the authors draw attention to the need for endoscopic surveillance in patients undergoing LSG, even in the absence of clinical signs of GERD.

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Introduction: Pancreatic resections belong to the most difficult surgical procedures and are still burdened with a high percentage of complications. Aim of the research: To analyse both the medical records of patients qualified for surgical treatment and the postoperative course after procedures of radical resection of the pancreas, with consideration of the most severe complications. Material and methods: Postoperative courses were analysed in 100 patients who had undergone pancreatic resection. Results: The most frequent indications for pancreatic resection were: cancer of the ampulla of Vater (30), pancreatic cancer (24), inflammatory tumours (16), and benign cystic tumours (12). In 8 cases, pancreatic resection (distal) was an element of the surgery due to advanced gastric cancer, while the remaining were: lymphoma (2), neuroendocrine tumour (2), adenoma with high-grade dysplasia involving the ampulla of Vater (2), GIST (1), IPMN (1), fibromatosis (1), and injury (1). The most frequently performed surgery was partial resection of the organ (73: proximal resection-35, distal resection-38). Total pancreatectomy was performed in 20 patients, and in 3 patients the surgery was limited to resection of the tumour. The dominant postoperative complications were pancreatic fistulas (9%) and haemorrhages (5%). Only one case of fistula was surgically treated. Surgical intervention was necessary in all cases of haemorrhagic complications (in 2 patients-several times). During the postoperative period 5 deaths were registered (5%). Conclusions: Pancreatic surgery remains a very difficult discipline, which requires not only excellent surgical technique, but also skill in the management of postoperative complications. Streszczenie Wprowadzenie: Resekcje trzustki należą do najtrudniejszych procedur chirurgicznych i nadal są obarczone dużym odsetkiem powikłań. Cel pracy: Analiza danych medycznych chorych zakwalifikowanych do leczenia operacyjnego oraz przebiegu pooperacyjnego po radykalnych zabiegach resekcyjnych trzustki u 100 chorych, z uwzględnieniem najcięższych powikłań. Materiał i metody: Retrospektywnej analizie klinicznej poddano przebiegi pooperacyjne u 100 chorych po zabiegach resekcyjnych trzustki. Medical Studies/Studia Medyczne 2018; 34/4 Wyniki: Najczęściej wskazaniami do resekcji trzustki były: rak brodawki Vatera (30), trzustki (24), guzy zapalne (16), łagodne guzy torbielowate (12). W 8 przypadkach resekcja trzustki (dystalna) była elementem operacji z powodu zaawansowanego raka żołądka. Pozostałe wskazania to: chłoniak (2), guz neuroendokrynny (2), gruczolak z dysplazją dużego stopnia brodawki Vatera (2), GIST (1), IPMN (1), fibromatoza (1), uraz (1). Najczęściej wykonywaną operacją było częściowe wycięcie narządu (73: resekcja proksymalna-35, resekcja dystalna-38). U 20 chorych wykonano całkowitą pankreatektomię; a u 3 chorych operacja ograniczyła się do wycięcia guza. Najczęstszymi powikłaniami pooperacyjnymi były przetoki trzustkowe (9%) oraz krwotoki (5%). Tylko 1 przypadek przetoki był leczony operacyjnie...

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