Table Of Content– the
”Οί παχὲες σφὸδρα κατὰ φὺσιν, ταχυθὰνατοι
γὶνονται μᾶλλον τῶν ἰσχνῶν”
“Those who are constitutionally very fat have less
power to successfully resist a severe disease”.
Hippocrates aphorisms II
Till Anna, Ebba och Agnes
List of Papers
This thesis is based on the following papers, which are referred to in the text
by their Roman numerals.
I Hedberg J, Hedenström H, Nilsson S, Sundbom M, Gustavsson
S. (2005) Role of gastric acid in stomal ulcer after gastric by-
pass. Obesity Surgery, 15(10): 1375-1378
II Hedberg J, Hedenström H, Sundbom M. Wire-less pH-metry at
the level of the gastrojejunostomy after Roux-en-Y gastric by-
pass-a novel use of the BRAVO™-system. Submitted
III Hedberg J, Hedenström H, Karlsson FA, Edén-Engström B,
Sundbom M. (2010) Gastric emptying and postprandial PYY-
response after biliopancreatic diversion with duodenal switch.
Obesity Surgery, E-pub ahead of print sept 2010
IV Hedbeg J, Gustavsson S, Sundbom M. Superior weight loss and
glucose control three years after duodenal switch compared to
Roux-en-Y gastric bypass. Submitted
Reprints were made with permission from the respective publishers.
Contents
Introduction ................................................................................................... 13
Background ................................................................................................... 14
Definitions and diagnostic methods ......................................................... 14
Epidemiology of obesity .......................................................................... 15
Risks of obesity ........................................................................................ 15
Diets and behavioral treatment of obesity ................................................ 16
Medical treatment of obesity .................................................................... 16
Surgical approaches to the treatment of obesity ....................................... 16
Gastric bypass, RYGBP ....................................................................... 17
Biliopancreatic diversion with duodenal switch, DS ........................... 19
Complications to RYGBP and DS ........................................................... 20
Acid secretion after RYGBP .................................................................... 23
Gastric emptying and pylorus function .................................................... 23
PYY .......................................................................................................... 24
Aims of this thesis ......................................................................................... 25
Patients and methods ..................................................................................... 26
Paper I ...................................................................................................... 26
Paper II ..................................................................................................... 26
Paper III .................................................................................................... 28
Paper IV ................................................................................................... 30
Ethics ........................................................................................................ 33
Results ........................................................................................................... 34
Paper I ...................................................................................................... 34
Paper II ..................................................................................................... 35
Paper III .................................................................................................... 40
Paper IV ................................................................................................... 42
General discussion ........................................................................................ 48
Conclusions ................................................................................................... 55
Paper I ...................................................................................................... 55
Paper II ..................................................................................................... 55
Paper III .................................................................................................... 55
Paper IV ................................................................................................... 55
Svensk sammanfattning (summary in Swedish) ........................................... 56
Delarbete I ........................................................................................... 56
Delarbete II .......................................................................................... 56
Delarbete III ......................................................................................... 57
Delarbete IV ........................................................................................ 57
Konklusioner ....................................................................................... 58
Acknowledgements ....................................................................................... 59
References ..................................................................................................... 62
Description:Hippocrates aphorisms II . Gastric emptying and pylorus function . Bariatric surgery was introduced in the 1950s and has been refined up until.
