David L Chengelis

Beaumont Health System · Department of General Surgery

Objective: To evaluate the effectiveness and safety of 3 predominant venous thromboembolism (VTE) prophylaxis strategies among patients undergoing bariatric surgery. Design: Cohort study. Setting: The Michigan Bariatric Surgery Collaborative, a statewide clinical registry and quality improvement program. Patients: Twenty-four thousand seven...

Anastomotic stenosis, leak, and hemorrhage are common stapler-related complications of laparoscopic Roux-en-Y gastric bypass. In May 2007, we transitioned from a 25-mm diameter, 4.8-mm-height circular stapler to a 25-mm, 3.5-mm-height circular stapler. We hypothesized that the staple height would be associated with a decreased incidence of perioper...

Introduction. Few data are available on vitamin A deficiency in the gastric bypass population. Methods. We performed a retrospective chart review of gastric bypass patients (n = 69, 74% female). The relationship between serum vitamin A concentration and markers of protein metabolism at 6-weeks and 1-year post-operative were assessed. Results. The...

Bariatric surgery has become a common treatment for morbid obesity. The relative changes in body tissue that comprise the substantial weight loss over time are not completely understood. We evaluated the differential rates of fat and lean tissue losses in morbidly obese patients who underwent Roux-en-Y gastric bypass surgery. Body composition was a...

After bariatric surgery, a lifelong threat of weight regain remains. Behavior influences are believed to play a modulating role in this problem. Accordingly, we sought to identify these predictors in patients with extreme obesity after Roux-en-Y gastric bypass (RYGB). In a large tertiary hospital with an established bariatric program, including a m...

Bariatric surgery achieves long-term weight loss in obese adults with improvement of diabetes and hypertension. Little is known about the effect of this weight loss on renal parameters. We performed a retrospective study of 94 obese adults who had Roux-en-Y gastric bypass surgery with a mean 12-month follow-up. Baseline (preoperative) mean age was...

Bariatric surgery achieves long-term weight loss in obese adults with amelioration of diabetes and hypertension. Improvement in albuminuria and high-sensitivity C-reactive protein (hs-CRP) has also been reported. We investigated, at a weight control center in a community hospital setting, the relation between degree of surgical weight loss and redu...

Background: The association between body mass index (BMI) and the development of type 2 diabetes (T2DM) is well established. The determinants of the resolution of T2DM with weight reduction after bariatric surgery, however, are not fully understood. Objective: Examine the course of T2DM during weight loss after bariatric surgery. Methods: Through a...

Upper gastrointestinal hemorrhage (UGIH) is an infrequent complication (1-3.8%) following laparoscopic Roux-en-Y gastric bypass (LRYGB). The safety and efficacy of endoscopic management of immediate postoperative bleeding is unknown. We sought to determine how frequently UGIH complicates LRYGB and whether endoscopic management is successful in cont...

Current vitamin D recommendations are insufficient and a higher intake is necessary in the general population. The requirements of bariatric surgery patients can be augmented by longstanding obesity coupled with, gastro-intestinal malabsorption. Vitamin D deficiency promotes metabolic bone disease and may increase risks for a multitude of other med...

In recent years, bariatric surgery has become an increasingly used therapeutic option for morbid obesity. The effect of weight loss after bariatric surgery on the predicted risk of coronary heart disease (CHD) has not previously been studied. We evaluated baseline (preoperative) and follow-up (postoperative) body mass index, CHD risk factors, and F...

Total caloric expenditure is the sum of resting energy expenditure (REE) and caloric expenditure during physical activity. In this study, we examined total caloric expenditure in 25 morbidly obese patients (body mass index>or=35 kg/m(2)) using dual energy X-ray absorptiometry (DXA) scanning and cardiorespiratory exercise testing. Our results show a...

Morbid obesity is associated with reduced functional capacity, multiple comorbidities, and higher overall mortality. The relationship between complications after bariatric surgery and preoperative cardiorespiratory fitness has not been previously studied. We evaluated cardiorespiratory fitness in 109 patients with morbid obesity prior to laparoscop...

Mean age was 46.0±10.4 years and 82 (75.2%) were female. Mean body mass index (BMI) was 48.1±7.5 kg/m2 and 50.4±6.0 kg/m2 for women and men, respectively p=0.17. VO2max measurements ranged from 6.8 to 27.7 ml/kg/min. Patients were stratified by tertile of VO2max. Mean VO2max in the first tertile was 13.7±2.1, second tertile was 17.1±0.8, and third...

We have evaluated the progression of isolated superficial venous thrombosis to deep vein thrombosis in patients with no initial deep venous involvement. Patients with thrombosis isolated to the superficial veins with no evidence of deep venous involvement by duplex ultrasound examination were evaluated by follow-up duplex ultrasonography to determi...

In the last 10 years, duplex ultrasound has provided new insights in the way superficial thrombophlebitis of the lower extremity is viewed. With above the knee greater saphenous disease, it is clear that the proximal extent of the thrombus is inaccurately predicted by physical exam in half of cases.1 In addition, concurrent DVT, not previously susp...

We have reviewed our early experience with intravascular ultrasound in the management of thoracic outlet syndrome. Eight patients presenting with symptoms of venous obstruction secondary to thoracic outlet syndrome have been evaluated by duplex ultrasound, contrast venography, and intravascular ultrasound (IVUS). IVUS was performed at the same time...