Bariatric surgery—which procedure is the optimal choice?

Bariatric surgery was originally designed to promote weight loss.1 Nowadays, bariatric surgery is often called metabolic surgery because the procedures, beyond weight loss, improve glycaemia, metabolic syndrome, and non-alcoholic liver disease, and decrease risk of cardiovascular disease more effect...

Full description

Saved in:
Bibliographic Details
Published in:The Lancet (British edition) 2019-03, Vol.393 (10178), p.1263-1264
Main Authors: Madsbad, Sten, Holst, Jens J
Format: Article
Language:English
Subjects:
Blood glucose
Cardiovascular diseases
Clinical trials
Diabetes
Diabetes mellitus
Gastrectomy
Gastric bypass
Gastrointestinal surgery
Health risks
Inflammation
Lipids
Liver
Liver diseases
Metabolic disorders
Metabolic syndrome
Metabolism
Mortality
Patients
Pharmacology
Surgery
Surgical outcomes
Weight loss
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Bariatric surgery was originally designed to promote weight loss.1 Nowadays, bariatric surgery is often called metabolic surgery because the procedures, beyond weight loss, improve glycaemia, metabolic syndrome, and non-alcoholic liver disease, and decrease risk of cardiovascular disease more effectively than any pharmacological or lifestyle approach.2,3 The two most common procedures are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy.4 RYGB has been in use for more than 30 years and the simpler gastric sleeve is the most used operation. Additional limitations include the small number of patients, the relatively short follow-up, and the 23% (n=57) loss of patients at follow-up, also decreasing the reliability of the primary endpoint. [...]the greatest value of this study is that it raises awareness regarding nutritional and inflammatory complications associated with OAGB, which otherwise seems to have similar metabolic effects to RYGB. In other words, even if the weight loss and anti-diabetic actions of a new procedure are attractive, no guarantee exists that its long-term safety profile is the same. [...]strict follow-up after bariatric surgery is important after new procedures, as well as old procedures.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(19)30489-1