الفهرس 
INTRODUCTION AND AIM OF THE WORK
Anatomy of the StomachOnly 14 pages are availabe for public view
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Abstract
Obesity is an increasing worldwide problem that is associated with significant morbidity and mortality Morbidly obese people are defined as those with body mass index greater than 40 kg /m2. Clinically severe obesity is associated with a large number of problems including coronary artery disease, hypertension, dyslipidaemia, Adult onset diabetes mellitus, hypoventillation, sleep apnoea, venous stasis as will as pulmonary embolism and death. Aim of work: Study of the hormonal, biochemical and radiological changes that occur after Roux-en Y Gastric Bypass in patients with clinically severe obesity and also aims to study the complications that may occur for patients after surgery including bone changes that may occur during the first year after surgery. Patients and methods: A total number of thirty patients with clinically severe obesity were studied during the period between April 2005 and July 2007 (inclusive). All patients were treated in the Endocrine Surgery Unit (ESU), Mansoura University Hospital. Obesity was diagnosed on the base of Body Mass Index (BMI). The patients were informed about the aim of the study and gave their written consent. Roux-en Y Gastric Bypass (RYGB) procedure was done for all patients. Results: In our study: females comprised 73% of cases. The mean age was 35 + 8.8 years. The abdominal wall thickness ranged between 7 cm up to 11 cm, with a mean of 8.8. Peroperative blood loss ranged from 100cc to 900cc, with a mean of 205cc. The operation time ranged from 90 to 180 minutes, with a mean of 113 minutes. Hospital stay ranged from 5 to 9 days, with a mean of 6.7 days. One year after RYGB: Body weight (BW) decreased significantly from 132.8 + 26.5 to 90.3 + 17.3 kg (p = 0.000). Body Mass Index (BMI) decreased significantly from 48 + 7.3 to 32.6 + 4.1 kg/m2 (p= 0.000). Also, parameters of skeletal health changes were determined after one year. BMC decreased significantly from 2968.6 + 71.4 to 2700.8 + 45.4 gm (p = 0.000) BMD decreased significantly from 1.026 + 0.03 to 1.22 + 0.015 gm/cm2 (p= 0.000). TBA decreased significantly from 2356.2 + 35.4 to 2216.3 + 43.5 cm2 (p= 0.000). Serum calcium, 24 hours urinary calcium and BSAP were non significantly decreased while OH-vitamin D and PTH were non significantly increased after surgery. Conclusions: from this study, RYGB gives very good results as regards reduction of body weight. Different endocrinal, biochemical and radiological changes occurs after Roux-en Y gastric bypass in patients with clinically severe obesity. Postoperative supplementation with calcium and vitamin D partially correct osteoporosis. Further studies are needed to determine the exact dose of calcium and vitamin D that may abort bone resorption.