Date of Award

Spring 2023

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Staveteig, Mindy

Second Advisor

Andvik, Vicki

Keywords

bariatric embolization, left gastric artery embolization, Roux-en-Y gastric bypass, bariatric patients, operation, procedure, minimally invasive, obesity

Abstract

The primary aim of this systematic literature review is to determine the safety and efficacy of left gastric artery embolization (LGAE) in comparison to Roux-en-Y gastric bypass (RYGB) for bariatric patients. A total of four prospective studies focusing on left gastric artery embolization were selected and reviewed. A total of five studies were selected that discussed Roux-en-Y gastric bypass. All studies used have a publication date of 10 years or less. The research shows evidence that RYGB, an invasive surgical operation, has been proven to result in long-term efficacy of weight loss but can be associated with a higher risk of early and long-term complications to include a gastrojejunal anastomosis leak, surgical site infection, iron deficiency anemia, bowel obstructions, and hernias. RYGB may require reoperation and does have a risk of mortality. Bariatric surgery is now focusing on the appetite-stimulating hormone, ghrelin, which may play a bigger role in reducing weight. LGAE is a safe, minimally invasive procedure and the evidence has shown promising results in suppression of ghrelin levels leading to significant weight reduction within one year. Adverse events of LGAE include epigastric discomfort, nausea, vomiting, and superficial gastric ulcers. In the studies selected, no deaths were observed following LGAE. It was concluded that LGAE is currently unable to reduce weight and appetite to the extent that RYGB can. However, future studies regarding LGAE will need to focus on proper procedural technique to maximize long-term efficacy and reduce adverse effects.

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