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Copyright of Lithuanian Surgery / Lietuvos Chirurgija is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Lithuanian Surgery / Lietuvos Chirurgija is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Lithuanian Surgery / Lietuvos Chirurgija is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chemija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the present work, analytical method for the determination of trace elements in adipose tissue by means of inductively coupled plasma optical emission spectrometry (ICP-OES) was developed. Adipose tissue from two groups of the patients with obesity (with and without metabolic syndrome) was investigated. The main aim of this study was to reveal some differences and regularities in concentrations of trace elements in adipose tissue between these two groups of the individuals. Moreover, different types of adipose tissue (subcutaneous, preperitoneal, and visceral) were analyzed separately in order to investigate distribution of metals between these types in different groups of obese people. Al, Ba, Ca, Co, Cu, Cr, Fe, K, Li, Mg, Mn, Na, Ni, Sr, and Zn were selected for the quantitative determination. However, only 6 elements (Na, K, Ca, Fe, Mg, and Zn) were determined in all analyzed samples independently of the type of adipose tissue and presence of metabolic disorder of the patient. Concentrations of Ca, Fe, K, and Na were found to be strongly dependent on the type of adipose tissue. Other elements in terms of detection frequency in adipose tissue samples can be arranged in the following sequence Sr (94.7%), Cr (86.2%), Cu (24.6%), Li (18%), Ba (1.8%), Co (0.05%). The concentrations of Al, Mn, and Ni were found to be lower than limit of detection (LOD) in all analyzed samples. Comparison of metal distribution depending on the type of adipose tissue of people with and without metabolic syndrome is discussed in this work. [ABSTRACT FROM AUTHOR]

Introduction: Laparoscopic adjustable gastric banding (LAGB) is considered to be the least invasive, reversible, and the safest bariatric operation regarding mortality and morbidity, and its application to high-risk superobese (SO) individuals seems rational. Aim: There are differing viewpoints regarding the effectiveness of LAGB in superobese (BMI > 50 kg/m²) patients. The aim of this study was to compare the safety and efficacy of LAGB in SO and non-superobese (NSO) patients in the long term (> 5 years). Material and methods: We undertook a prospective single-center study to compare the safety and efficacy of LAGB in SO and NSO patients after 5 years. One hundred and three morbidly obese patients underwent LAGB in the period from January 2009 to January 2010. Sixty-four of the patients were NSO and 39 SO. After 5 years, we evaluated their weight loss, comorbidities, complications, and quality of life. Results: A total of 90 of 103 patients (87.3%) completed the 5-year follow-up. The percentage excess weight loss was 50.4% in the NSO and 38.8% in the SO group (p = 0.072). The proportion of patients who lost > 50% excess weight was significantly larger in the NSO group (p = 0.045). There were significantly more patients in the NSO group whose metabolic syndrome had resolved (p < 0.001). There were no differences regarding the resolution of other comorbidities and postoperative complications. Conclusions: This study suggests that LAGB can lead to substantial and long-lasting weight loss after 5 years. Our study found that SO patients demonstrate inferior weight loss results, and lower overall BAROS scores; thus we do not support the primary use of LAGB in SO patients. [ABSTRACT FROM AUTHOR]

Copyright of Chemija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chemija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. Aim: To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. Material and methods: A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization. Results: The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01). Conclusions: In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients. [ABSTRACT FROM AUTHOR]

Introduction: There are insufficient data regarding the changes in adipokine levels after laparoscopic adjustable gastric banding (LAGB) in diabetic and non-diabetic patients and their effects on insulin resistance and type 2 diabetes remission. Aim: To assess leptin, adiponectin, and insulin resistance changes after LAGB in diabetic and non-diabetic morbidly obese patients. Material and methods: One hundred and three patients (37 with and 66 without type 2 diabetes) underwent LAGB from January 2009 to January 2010. Glycated hemoglobin, insulin, adipokine levels and insulin resistance were evaluated preoperatively, and 1 and 4 years after LAGB. Results: The mean patient age was 45.9 ± 11.7 years and mean preoperative body mass index was 47.5 ± 7.3 kg/m². A total of 80 of 103 patients (77.6%) completed the 4-year follow-up. After 4 years the mean excess weight loss was 38.8% and 39.5% in diabetic and non-diabetic patients respectively. Leptin levels decreased significantly in both groups at 1 year, but after 4 years this was noted only in non-diabetic patients. After 1 year adiponectin levels increased significantly only in non-diabetic patients (p = 0.003) and remained almost the same at 4 years. A significant decrease in insulin resistance was noted in both groups 1 year after LAGB and diabetes remission was observed in 23 (62.1%) patients. There was a negative correlation between preoperative insulin resistance and adiponectin levels throughout the follow-up period. Leptin levels positively correlated with BMI throughout the study period (baseline r = 0.45; p < 0.001; after 1 year r = 0.71; p < 0.001; after 4 years r = 0.68; p < 0.001). There was no significant correlation between leptin and adiponectin concentrations preoperatively or after 1 year; however, at 4 years it was significant (r = 0.27; p < 0.02). Conclusions: The most significant metabolic changes occurred within 1 year after LAGB. The 4-year follow-up revealed stabilization in metabolic indices rather than significant improvement. [ABSTRACT FROM AUTHOR]

Background: Various types of adjustable gastric bands are used during LAGB, but there is insufficient data comparing different bands in the long term. We carried out a prospective randomized study to compare two different bands. Methods: Between January 1, 2009 and January 31, 2010, 103 morbidly obese patients were randomized between SAGB and MiniMizer Extra adjustable gastric bands. The SAGB was used in 49 and MiniMizer Extra in 54 patients. Weight loss, comorbidities, long-term complications, and quality of life were evaluated after 5 years. Results: Patient baseline characteristics were similar in the two groups. The mean patient age was 45.9 ± 11.7 years, and mean preoperative BMI was 47.5 ± 7.3 kg/m. A total of 90 of 103 patients (87.3 %) completed the 5-year follow-up. The mean excess weight loss was 44.1 and 50.3 % in SAGB and MiniMizer groups, respectively ( p = 0.14). A proportion of patients who reached a BMI < 35 kg/m was significantly larger in MiniMizer Extra group (52.9 vs 25.5 %; p = 0.01). Complications developed in 15 patients (14.5 %) and consisted of 5 band erosions, 4 port-related complications, 3 band slippages, and 3 band intolerances. All five band erosions developed in MiniMizer Extra group, but the difference was not significant ( p = 0.058). No difference was found regarding postoperative complications, resolution of comorbidities, and quality of life between compared groups. Conclusions: SAGB and MiniMizer Extra bands demonstrated similar long-term results regarding the weight loss, resolution of comorbidities, morbidity, and quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Chemija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP).Methods: Prospective study was conducted in four clinical centers. The diagnosis and severity assessment of AP was established according to the revised 2012 Atlanta classification. Adipokines, IL-6 and CRP levels were measured at admission and on 3rd day of hospital stay and compared with the control group. The predictive accuracy of each marker was measured by area under the receiver operating curve.Results: Forty healthy controls and 102 patients were enrolled in to the study. Twenty seven (26.5 %) patients had mild, 55 (53.9 %) - moderate and 20 (19.6 %) - severe AP. Only resistin (cut-off value 13.7 ng/ml) and IL-6 (cut-off value 473.4 pg/ml) were reliable early markers of SAP. IL-6 with cut-off value of 157.0 pg/ml was a predictor of necrosis. The peripancreatic necrosis volume of 112.5 ml was a marker of SAP and 433.0 ml cut-off value could be used to predict the need of interventions.Conclusions: The prognostic value of adipokines in AP is limited. Only admission resistin levels could serve as an early predictor for SAP. The Lithuanian Regional Ethics Committee approved the study protocol (permission No. L-12-02/1/2/3/4) and all the patients and the control group provided written informed consent. [ABSTRACT FROM AUTHOR]

Copyright of Chemija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Laparoscopic adjustable gastric banding (LAGB) is effective for weight reduction in severely obese patients. However, the data about its effect on metabolic syndrome (MS) are limited. Aim: To assess weight loss and changes of metabolic parameters 1 year after LAGB in a prospective, nonrandomized single center cohort study in morbidly obese subjects. Material and methods: Physical examination, body weight (BW) parameters and metabolic profile were assessed at baseline and 1 year after LAGB in morbidly obese subjects. The incidence of MS was evaluated according to National Cholesterol Education Program Adult Treatment Panel III criteria. Results: One year after the operation data from 90 patients out of 103 were available. Mean excess weight (EW) loss of 33.1% was associated with a significant improvement in all metabolic parameters: decrease of hypertension by 15.8%, hypertriglyceridemia by 42.6%, and hyperglycemia by 46.3%; and increase in high density lipoprotein cholesterol by 48.3%. This resulted in the resolution of MS in 44.2% of subjects. The significant change in the distribution ofMS components was observed with the highest frequency of 4 components before and 2 components after surgery. Patients with MS at baseline lost 29.9% of EW compared to 44.3% in those without MS (p = 0.009). Conclusions: The LAGB resulted in effective reduction of BW parameters in morbidly obese subjects 1 year after the operation. Along with the weight loss, resolution of MS and a significant shift towards decrease in the number of MS components was observed. Patients with MS were more resistant to the weight loss. [ABSTRACT FROM AUTHOR]

Background: The increasing weight of Lithuanians represents one of the greatest challenges confronting the medical society. The most effective treatment for morbid obesity is bariatric surgery, showing low major morbidity and mortality. Modern bariatric surgery was started in Lithuania with laparoscopic adjustable gastric banding (LAGB) in 2004. However, there is no published data concerning its results in the case of this particular ethnic population thus far. Patients and Methods: From April 2004 to June 2006, 100 patients underwent LAGB. Mean age was 45.8 years, preoperative body weight 136.2 kg and body mass index (BMI) 48.4 kg/m2. Data of clinical status, complications, initial excess weight loss (%IEWL), BMI and Bariatric Analysis and Reporting Outcome System (BAROS) were used for postoperative evaluation. Results: 15.1% of Lithuanian adults are obese, 20.3% of these have BMI > 35 kg/m2 and 7% BMI > 40 kg/m2. 100 consecutive patients treated with LAGB were evaluated postoperatively. The postoperative average %IEWL amounted to 38, 57, 72 and 84% after 6, 12, 18 and 24 months, respectively. There were complications in 3 patients but no postoperative deaths. Conclusions: The prevalence of obesity in Lithuanian adults is 15.1%. In a 1-year follow-up period LAGB proved to be effective for treatment of morbid obesity, with low complications rate and improved quality of life according to BAROS. LAGB results need to be verified in long-term follow-up. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Lituanica is the property of Vilnius University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A letter to the editor is presented in response to the article on de garengeot hernia.