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4. Esophageal and gastric malignancies after bariatric surgery: a retrospective global study

Author

Gallardo, Carlos Sosa, Agustin, Cataldo, Wright, Fernando, Fuente, Ignacio, Carbajo, Miguel, Cal, Patricio, Chisholm, Jacob, Kow, Lilian, Tan, Michael H.L., Gan, Philip, Gananadha, Sivakumar, Felsenreich, Daniel M., Prager, Gerhard, Matthys, Chris, Himpens, Jacques M., Focquet, Marc A.M.R.M., Ramos, Almino, Nato, Manoel Galvano, Vidal, Thiago, Andalib, Amin, Siblini, Aya, Ferri, Lorenzo, Abdarabo, Lina, Nevo, Yehonatan, Pescarus, Radu, Yang, Wah, Hamed, Hosam, Liagre, Arnaud, Bergeat, Damien, Marie, De Montrichard, Martini, Francesco, Regis, François, Genser, Laurent, Skalli, Mehdi, Nedelcu, Marius, Smejkal, Milan, Kassir, Radwan, Nicolas, Regenet, Stier, Christine, Nedelcut, Dan-Sebastian, Christodoulidis, Grigorios, Vennapusa, Amar, Kermansaravi, Mohammad, Raziel, Asnat, Sakran, Nasser, Oldani, Alberto, Boru, Cristian Eugeniu, Mécheri, Fouzia, Ciccarese, Francesca, Cesana, Giovanni Carlo, Musella, Mario, Uccelli, Matteo, Foletto, Mirto, Auricchio, Pasquale, Olmi, Stefano, Seki, Yosuke, Kasteleijn, Anne, Van 'T Hof, Gerhard, Apers, Jan A., Hart, Judith W.H., Van De Sande, Justin S.L., Takkenberg, Marijn, Feskens, Pierre B.G.M., Snoekx, Rob, Plat, Victor D., Sandvik, Jorunn, Kalinowski, Piotr, Nabais, Celso, Al-Bahrani, Ahmed Z., Al Zoubi, Mohammad, Bettonica, Carla, Osorio, Javier, Tejedor-Tejada, Javier, Sanz, Lourdes M., Cuadrado, Marta, Moorjani, Rajesh Gianchandani, Yannick, Fringeli, Suter, Michel, Borbély, Yves, Joerg, Zehetner, Barajas-Gamboa, Juan S., Kroh, Matthew, Kisiel, Aaron P., Kamocka, Anna, Immanuel, Arul, Sgromo, Bruno, Gopinath, Bussa, Khoo, David, Mukherjee, Samrat, Pournaras, Dimitrios, Underwood, Tim, Griffiths, Ewen A., Miller, Glenn V., Jaretzke, Helen, Dmitrewski, Jan, Wadley, Martin S., Al-Housni, Ragad, Gillies, Richard S., Singhal, Rishi, Preston, Shaun R., Robinson, Steven John, Hawkins, William J., Adamo, Marco, El Kalaawy, Mohamed, Gossage, James, Crawford, Christopher B., Jaruvongvanich, Veeravich, Parmar, Chetan, Zakeri, Roxanna, Abouelazayem, Mohamed, Shin, Thomas H., Aminian, Ali, Mahmoud, Tala, Abu Dayyeh, Barham K., Wee, Melissa Y., Fischer, Laura, Daams, Freek, and Mahawar, Kamal

Published
2022
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6. Peroperative administration of tranexamic acid in Roux-en-Y and one-anastomosis gastric bypass to reduce haemorrhage in patients with morbid obesity: protocol for randomised controlled trial (PATRY trial)

Author

't Hart, Judith W H, primary, Noordman, Bo J, additional, Palsgraaf-Huisbrink, Jeannine, additional, Dunkelgrun, Martin, additional, Zengerink, Hans F, additional, Birnie, Erwin, additional, van Det, Marc J, additional, Boerma, Evert-Jan G, additional, de Castro, Steve M M, additional, Hazebroek, Eric J, additional, Langenhoff, Barbara S, additional, Verhoef, Cornelis, additional, and Apers, Jan A, additional

Published
2024
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8. Long-term effect of sleeve gastrectomy vs Roux-en-Y gastric bypass in people living with severe obesity:a phase III multicentre randomised controlled trial (SleeveBypass)

Author

Biter, L. Ulas, ‘t Hart, Judith WH, Noordman, Bo J., Smulders, J. Frans, Nienhuijs, Simon, Dunkelgrün, Martin, Zengerink, Johannes F., Birnie, Erwin, Friskes, Irene AM, Mannaerts, Guido HH, Apers, Jan A., Biter, L. Ulas, ‘t Hart, Judith WH, Noordman, Bo J., Smulders, J. Frans, Nienhuijs, Simon, Dunkelgrün, Martin, Zengerink, Johannes F., Birnie, Erwin, Friskes, Irene AM, Mannaerts, Guido HH, and Apers, Jan A.

Abstract

Background: Sleeve gastrectomy is the most performed metabolic surgical procedure worldwide. However, conflicting results offer no clear evidence about its long-term clinical comparability to Roux-en-Y gastric bypass. This study aims to determine their equivalent long-term weight loss effects. Methods: This randomised open-label controlled trial was conducted from 2012 until 2017 in two Dutch bariatric hospitals with a 5-year follow-up (last follow-up July 29th, 2022). Out of 4045 patients, 628 were eligible for metabolic surgery and were randomly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass (intention-to-treat). The primary endpoint was weight loss, expressed by percentage excess body mass index (BMI) loss. The predefined clinically relevant equivalence margin was −13% to 13%. Secondary endpoints included percentage total kilograms weight loss, obesity-related comorbidities, quality of life, morbidity, and mortality. This trial is registered with Dutch Trial Register NTR4741: https://onderzoekmetmensen.nl/nl/trial/25900. Findings: 628 patients were randomised between sleeve gastrectomy (n = 312) and Roux-en-Y gastric bypass (n = 316) (mean age 43 [standard deviation (SD), 11] years; mean BMI 43.5 [SD, 4.7]; 81.8% women). Excess BMI loss at 5 years was 58.8% [95% CI, 55%–63%] after sleeve gastrectomy and 67.1% [95% CI, 63%–71%] after Roux-en-Y gastric bypass (difference 8.3% [95% CI, −12.5% to −4.0%]). This was within the predefined margin (P < 0.001). Total weight loss at 5 years was 22.5% [95% CI, 20.7%–24.3%] after sleeve gastrectomy and 26.0% [95% CI, 24.3%–27.8%] after Roux-en-Y gastric bypass (difference 3.5% [95% CI, −5.2% to −1.7%]). In both groups, obesity-related comorbidities significantly improved after 5 years. Dyslipidaemia improved more frequently after Roux-en-Y gastric bypass (83%, 54/65) compared to sleeve gastrectomy (62%, 44/71) (P = 0.006). De novo gastro-oesophageal reflux disease occurred more frequently after sleeve gastre

Published
2024

14. The Management of Biliary Disease in Patients with Severe Obesity Undergoing Metabolic and Bariatric Surgery—An International Expert Survey.

Author

Kermansaravi, Mohammad, Shikora, Scott, Dillemans, Bruno, Kurian, Marina, LaMasters, Teresa, Vilallonga, Ramon, Prager, Gerhard, Chiappetta, Sonja, Aaarts, Edo, Abbas, Imran, Aghajani, Ebrahim, Angrisani, Luigi, Antozzi, Luciano, Apers, Jan, Asghar, Tanseer, Bashir, Ahmad, Behrens, Estuardo, Billy, Helmuth, Caina, Daniel, and Carbajo, Miguel‑A.

Subjects
BILIOUS diseases & biliousness, GALLSTONES, GASTRIC bypass, BARIATRIC surgery, DISEASE management, WEIGHT loss
Abstract

Objective: This study aimed to survey international experts in metabolic and bariatric surgery (MBS) to improve and consolidate the management of biliary disease in patients with severe obesity undergoing MBS. Background: Obesity and rapid weight loss after MBS are risk factors for the development of gallstones. Complications, such as cholecystitis, acute cholangitis, and biliary pancreatitis, are potentially life-threatening, and no guidelines for the proper management of gallstone disease exist. Methods: An international scientific team designed an online confidential questionnaire with 26 multiple-choice questions. The survey was answered by 86 invited experts (from 38 different countries), who participated from August 1, 2023, to September 9, 2023. Results: Two-thirds of experts (67.4%) perform concomitant cholecystectomy in symptomatic gallstones during MBS. Half of experts (50%) would wait 6–12 weeks between both surgeries with an interval approach. Approximately 57% of the experts prescribe ursodeoxycholic acid (UDCA) prophylactically after MBS, and most recommend a 6-month course. More than the half of the experts (59.3%/53.5%) preferred laparoscopic assisted transgastric ERCP as the approach for treating CBD stones in patients who previously had RYGB/OAGB. Conclusion: Concomitant cholecystectomy is preferred by the experts, although evidence in the literature reports an increased complication rate. Prophylactic UDCA should be recommended to every MBS patient, even though the current survey demonstrated that not all experts are recommending it. The preferred approach for treating common bile duct stones is a laparoscopic assisted transgastric ERCP after gastric bypass. The conflicting responses will need more scientific work and clarity in the future. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Effect of bariatric surgery on NAFLD/NASH: a single-centre observational prospective cohort study

Author

Theel, Willy B, primary, Boxma-de Klerk, Bianca M, additional, Dirksmeier-Harinck, Femme, additional, van Rossum, Elisabeth FC, additional, Kanhai, Danny A, additional, Apers, Jan A, additional, van Dalen, Bas M, additional, De Knegt, Robert J, additional, Neecke, Bojou, additional, van der Zwan, Ellen M, additional, Grobbee, Diederick E, additional, Hankemeier, Thomas, additional, Wiebolt, Janneke, additional, and Castro Cabezas, Manuel, additional

Published
2023
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17. Effect of bariatric surgery on NAFLD/NASH:a single-centre observational prospective cohort study

Author

Theel, Willy B., Boxma-De Klerk, Bianca M., Dirksmeier-Harinck, Femme, Van Rossum, Elisabeth F.C., Kanhai, Danny A., Apers, Jan A., Van Dalen, Bas M., De Knegt, Robert J., Neecke, Bojou, Van Der Zwan, Ellen M., Grobbee, Diederick E., Hankemeier, Thomas, Wiebolt, Janneke, Castro Cabezas, Manuel, Theel, Willy B., Boxma-De Klerk, Bianca M., Dirksmeier-Harinck, Femme, Van Rossum, Elisabeth F.C., Kanhai, Danny A., Apers, Jan A., Van Dalen, Bas M., De Knegt, Robert J., Neecke, Bojou, Van Der Zwan, Ellen M., Grobbee, Diederick E., Hankemeier, Thomas, Wiebolt, Janneke, and Castro Cabezas, Manuel

Abstract

Introduction The prevalence of non-alcoholic fatty liver disease (NAFLD) ranges from 25% in the general population to 90% in patients with obesity scheduled for bariatric surgery. NAFLD can progress towards non-alcoholic steatohepatitis (NASH) associated with complications such as cirrhosis, hepatocellular carcinoma and cardiovascular disease. To date, losing weight and lifestyle modifications are the best known treatments for NASH. Bariatric surgery significantly improves NAFLD/NASH in the short term. However, the extent of this improvement is not yet clear and long-term data on the natural course of NAFLD/NASH after bariatric surgery are lacking. The factors involved in NAFLD/NASH regression after bariatric surgery have not been elucidated. Methods and analysis This is an observational prospective cohort study including patients scheduled for bariatric surgery. Extensive metabolic and cardiovascular analyses will be carried out including measurements of carotid intima media thickness and pulse wave velocity. Genomic, proteomic, lipidomic and metabolomic studies will be done. Microbioma analyses before and 1 year after surgery will be done. Transient elastography measurements will be performed before and at 1, 3 and 5 years after surgery. For those with an elevated preoperative transient elastography measurement by Fibroscan, a laparoscopic liver biopsy will be performed during surgery. Primary outcome measures are the change of steatosis and liver fibrosis 5 years after surgery. Secondary outcome measure is the comparison of the transient elastography measurements with the NAFLD Activity Score from the biopsies. Ethics and dissemination The protocol has been approved by the Medical Research Ethics Committees United, Nieuwegein, on 1 March 2022 (registration code R21.103/NL79423.100.21). The study results will be submitted for publication in peer-reviewed journals and data will be presented at scientific meetings. Trial registration number NCT05499949.

Published
2023

22. Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey

Author

Musella, Mario, Apers, Jan, Rheinwalt, Karl, Ribeiro, Rui, Manno, Emilio, Greco, Francesco, Čierny, Michal, Milone, Marco, Di Stefano, Carla, Guler, Sahin, Van Lessen, Isa Mareike, Guerra, Anabela, Maglio, Mauro Natale, Bonfanti, Riccardo, Novotna, Radoslava, Coretti, Guido, and Piazza, Luigi

Published
2016
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24. Evaluation of nonalcoholic fatty liver disease (NAFLD) in severe obesity using noninvasive tests and imaging techniques

Author

Theel, Willy, primary, Boxma‐de Klerk, Bianca M., additional, Dirksmeier‐Harinck, Femme, additional, van Rossum, Elisabeth F. C., additional, Kanhai, Danny A., additional, Apers, Jan, additional, van Dalen, Bas M., additional, de Knegt, Robert J., additional, Holleboom, Anthony G., additional, Tushuizen, Maarten E., additional, Grobbee, Diederick E., additional, Wiebolt, Janneke, additional, and Castro Cabezas, Manuel, additional

Published
2022
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26. Esophageal and gastric malignancies after bariatric surgery: a retrospective global study

Author

Parmar, Chetan, primary, Zakeri, Roxanna, additional, Abouelazayem, Mohamed, additional, Shin, Thomas H., additional, Aminian, Ali, additional, Mahmoud, Tala, additional, Abu Dayyeh, Barham K., additional, Wee, Melissa Y., additional, Fischer, Laura, additional, Daams, Freek, additional, Mahawar, Kamal, additional, Gallardo, Carlos Sosa, additional, Agustin, Cataldo, additional, Wright, Fernando, additional, Fuente, Ignacio, additional, Carbajo, Miguel, additional, Cal, Patricio, additional, Chisholm, Jacob, additional, Kow, Lilian, additional, Tan, Michael H.L., additional, Gan, Philip, additional, Gananadha, Sivakumar, additional, Felsenreich, Daniel M., additional, Prager, Gerhard, additional, Matthys, Chris, additional, Himpens, Jacques M., additional, Focquet, Marc A.M.R.M., additional, Ramos, Almino, additional, Nato, Manoel Galvano, additional, Vidal, Thiago, additional, Andalib, Amin, additional, Siblini, Aya, additional, Ferri, Lorenzo, additional, Abdarabo, Lina, additional, Nevo, Yehonatan, additional, Pescarus, Radu, additional, Yang, Wah, additional, Hamed, Hosam, additional, Liagre, Arnaud, additional, Bergeat, Damien, additional, Marie, De Montrichard, additional, Martini, Francesco, additional, Regis, François, additional, Genser, Laurent, additional, Skalli, Mehdi, additional, Nedelcu, Marius, additional, Smejkal, Milan, additional, Kassir, Radwan, additional, Nicolas, Regenet, additional, Stier, Christine, additional, Nedelcut, Dan-Sebastian, additional, Christodoulidis, Grigorios, additional, Vennapusa, Amar, additional, Kermansaravi, Mohammad, additional, Raziel, Asnat, additional, Sakran, Nasser, additional, Oldani, Alberto, additional, Boru, Cristian Eugeniu, additional, Mécheri, Fouzia, additional, Ciccarese, Francesca, additional, Cesana, Giovanni Carlo, additional, Musella, Mario, additional, Uccelli, Matteo, additional, Foletto, Mirto, additional, Auricchio, Pasquale, additional, Olmi, Stefano, additional, Seki, Yosuke, additional, Kasteleijn, Anne, additional, Van 'T Hof, Gerhard, additional, Apers, Jan A., additional, Hart, Judith W.H., additional, Van De Sande, Justin S.L., additional, Takkenberg, Marijn, additional, Feskens, Pierre B.G.M., additional, Snoekx, Rob, additional, Plat, Victor D., additional, Sandvik, Jorunn, additional, Kalinowski, Piotr, additional, Nabais, Celso, additional, Al-Bahrani, Ahmed Z., additional, Al Zoubi, Mohammad, additional, Bettonica, Carla, additional, Osorio, Javier, additional, Tejedor-Tejada, Javier, additional, Sanz, Lourdes M., additional, Cuadrado, Marta, additional, Moorjani, Rajesh Gianchandani, additional, Yannick, Fringeli, additional, Suter, Michel, additional, Borbély, Yves, additional, Joerg, Zehetner, additional, Barajas-Gamboa, Juan S., additional, Kroh, Matthew, additional, Kisiel, Aaron P., additional, Kamocka, Anna, additional, Immanuel, Arul, additional, Sgromo, Bruno, additional, Gopinath, Bussa, additional, Khoo, David, additional, Mukherjee, Samrat, additional, Pournaras, Dimitrios, additional, Underwood, Tim, additional, Griffiths, Ewen A., additional, Miller, Glenn V., additional, Jaretzke, Helen, additional, Dmitrewski, Jan, additional, Wadley, Martin S., additional, Al-Housni, Ragad, additional, Gillies, Richard S., additional, Singhal, Rishi, additional, Preston, Shaun R., additional, Robinson, Steven John, additional, Hawkins, William J., additional, Adamo, Marco, additional, El Kalaawy, Mohamed, additional, Gossage, James, additional, Crawford, Christopher B., additional, and Jaruvongvanich, Veeravich, additional

Published
2022
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31. Effect of Roux-en-Y gastric bypass on the bioavailability of metoprolol from immediate and controlled release tablets: a single oral dose study before and after surgery

Author

Yska, Jan Peter, primary, Wanders, Jacquelien T M, additional, Odigie, Blessing, additional, Apers, Jan A, additional, Emous, Marloes, additional, Totté, Erik R E, additional, Boerma, E Christiaan, additional, Ubels, Froukje L, additional, Woerdenbag, Herman J, additional, Frijlink, Henderik W, additional, Wilffert, Bob, additional, and van Roon, Eric N, additional

Published
2019
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34. The Standardized Postoperative Checklist for Bariatric Surgery; a Tool for Safe Early Discharge?

Author

Mil, Stefanie, Duinhouwer, Lucia, Mannaerts, Guido, Biter, L., Dunkelgrun, Martin, and Apers, Jan

Subjects
BARIATRIC surgery, OVERWEIGHT persons, SURGICAL complications, NAUSEA, HEART beat
Abstract

Background: Morbidly obese patients are at higher risk of complications after surgery. In bariatric surgery, pre- and intra-operative checklists are commonly used to identify high-risk patients preoperatively, to decrease the number of postoperative complications. This pilot study evaluates the effect of a postoperative checklist in bariatric surgery, addressing regularly measured parameters, on the occurrence and early recognition of complications. Methods: An in-house developed postoperative checklist was used on the first postoperative day after bariatric surgery and included information on nausea, pain, temperature, heart rate, and laboratory markers. Complications were scored using the Clavien-Dindo (CD) classification, and three groups were formed: no complications (CD0), minor complications (CD1 and 2), and major complications (≥CD3a). Differences between groups were analyzed using nonparametric tests. Results: Six hundred ninety-four subjects were included (79.5% female, age 42.6 ± 10.8 years, BMI 43.8 ± 5.8 kg/m). Twenty-nine subjects developed major complications within 30 days postoperatively. There were no significant differences in baseline characteristics between groups. Subjects with major complications were less willing to be discharged due to complaints, compared to subjects with no or minor complications (14.8 vs. 3.6 and 4.6%, respectively) and had a higher decrease of hemoglobin level (0.8 vs. 0.6 and 0.65 mmol/l, respectively). Conclusion: The patient's willingness for discharge, in combination with hemoglobin decrease, may be the best early predictors of major complications after bariatric surgery. This postoperative checklist may be an adequate instrument to identify patients who can be safely discharged home on the first postoperative day and thereby play a part in patient management after bariatric surgery. [ABSTRACT FROM AUTHOR]

Published
2017
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35. Influence of bariatric surgery on the use of medication

Author

Yska, Jan Peter, primary, van der Meer, Douwe H., additional, Dreijer, Albert R., additional, Eilander, Willeke, additional, Apers, Jan A., additional, Emous, Marloes, additional, Totté, Erik R. E., additional, Wilffert, Bob, additional, and van Roon, Eric N., additional

Published
2015
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37. Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey

Author

Musella, Mario, primary, Apers, Jan, additional, Rheinwalt, Karl, additional, Ribeiro, Rui, additional, Manno, Emilio, additional, Greco, Francesco, additional, Čierny, Michal, additional, Milone, Marco, additional, Di Stefano, Carla, additional, Guler, Sahin, additional, Van Lessen, Isa Mareike, additional, Guerra, Anabela, additional, Maglio, Mauro Natale, additional, Bonfanti, Riccardo, additional, Novotna, Radoslava, additional, Coretti, Guido, additional, and Piazza, Luigi, additional

Published
2015
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40. Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey

Author

Riccardo Bonfanti, Guido Coretti, Carla Di Stefano, Emilio Manno, Anabela Guerra, Radoslava Novotna, Mario Musella, Jan A Apers, Francesco Greco, Isa Mareike Van Lessen, Luigi Piazza, Sahin Guler, Marco Milone, Karl P. Rheinwalt, Michal Čierny, Rui Ribeiro, Mauro Natale Maglio, Musella, Mario, Apers, Jan, Rheinwalt, Karl, Ribeiro, Rui, Manno, Emilio, Greco, Francesco, Čierny, Michal, Milone, Marco, Di Stefano, Carla, Guler, Sahin, Van Lessen, Isa Mareike, Guerra, Anabela, Maglio, Mauro Natale, Bonfanti, Riccardo, Novotna, Radoslava, Coretti, Guido, and Piazza, Luigi

Subjects
Adult, Male, Sleeve gastrectomy, medicine.medical_specialty, Remission, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Gastric Bypass, T2DM, 030209 endocrinology & metabolism, Anastomosis, 03 medical and health sciences, 0302 clinical medicine, Gastrectomy, Weight loss, Diabetes mellitus, Weight Loss, medicine, SG, Humans, Mini gastric bypass/one anastomosis gastric bypa, MGB/OAGB, Retrospective Studies, Bariatric surgery, CHLC CIR, Nutrition and Dietetics, business.industry, Type 2 Diabetes Mellitus, Retrospective cohort study, Middle Aged, medicine.disease, Health Surveys, Obesity, Morbid, Surgery, Type 2 diabetes mellitu, Treatment Outcome, Diabetes Mellitus, Type 2, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, European multicenter survey, Body mass index, Follow-Up Studies
Abstract

BACKGROUND: A retrospective study was undertaken to define the efficacy of both mini gastric bypass or one anastomosis gastric bypass (MGB/OAGB) and sleeve gastrectomy (SG) in type 2 diabetes mellitus (T2DM) remission in morbidly obese patients (pts). METHODS: Eight European centers were involved in this survey. T2DM was preoperatively diagnosed in 313/3252 pts (9.62%). In 175/313 patients, 55.9% underwent MGB/OAGB, while in 138/313 patients, 44.1% received SG between January 2006 and December 2014. RESULTS: Two hundred six out of 313 (63.7 %) pts reached 1 year of follow-up. The mean body mass index (BMI) for MGB/OAGB pts was 33.1 ± 6.6, and the mean BMI for SG pts was 35.9 ± 5.9 (p 10 years (OR = 0.752, 95% CI 0.512-0.976, p = 0.01) were negative predictors whereas MGB/OAGB resulted as a positive predictor (OR = 3.888, 95% CI 1.654-9.143, p = 0.002) of diabetes remission. CONCLUSIONS: A significant BMI decrease and T2DM remission unrelated from weight loss were recorded for both procedures if compared to baseline values. At univariate and multivariate analyses, MGB/OAGB seems to outperform significantly SG. Four independent variables able to influence T2DM remission at 12 months have been identified. info:eu-repo/semantics/publishedVersion

Published
2015

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