Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB).
All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.
Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).
Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort.
We studied all patients (n = 147) discharged from the orthopedic wards at Kärnsjukhuset, Skövde, during a four week period. Two thirds had been admitted via emergency rooms, were older, used more medicines and had more diagnoses than the elective patients, and they required a great deal of medical resources. 38% of the emergency patients did not require specific orthopedic care. 47% of these were more than 80 years of age, had several diagnoses, and had been in-patients in at least two departments during the past year. There is a need for enhanced cooperation and information between departments in order to better provide care for elderly patients with more than one diagnosis.
To compare early results after pancreaticoduodenectomy depending on variant of pancreatico-digestive anastomosis.
It was analyzed early results of 207 pancreaticoduodenectomies for cancer which were performed for the period 2010-2014. Pancreatointestinal and pancreatogastric anastomoses were applied in 165 and 42 patients respectively.
Complications were observed in 73 (44.2%) and 18 (38.3%) patients after pancreatointestinal and pancreatogastric anastomoses respectively. Six patients died after pancreatointestinal anastomosis. At the same time there were no deaths in the group of pancreatogastric anastomosis. Differences were significant. Postoperative hospital-stay was similar in both groups.
Complications after 454 various operations on the liver are analysed. Abscesses of the upper part of the abdominal cavity (subdiaphragmatic and subhepatic abscesses, suppuration of residual cavities after resection of the liver and echinococcotomy) developed in 18.5% of patients in the postoperative period. Inadequate drainage of the abdominal cavity was among the main causes of such complications. The authors suggest an original method for drainage of the abdominal cavity after operations on the liver. With its use the number of these complications was three times less. It was found that in 40.5% of cases abscesses of the upper abdominal cavity may be cured by nonoperative measures, by puncture of the purulent cavity under control of ultrasonic examination and introduction of drains for subsequent aspiration. A surgical intervention is still the main method for the treatment of abscesses of the upper abdominal cavity. The success of the operation is determined to a great measure by effective drainage. A drainage method is suggested which allowed the time needed for the treatment in cases with such complications to be reduced almost by half.