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[Bariatric surgery: an update].

B Moreno Esteban1, A Zugasti Murillo

  • 1Unidad de Obesidad, Hospital General Universitario Gregorio Marañón, Madrid. bmoreno@arrakis.es

Revista De Medicina De La Universidad De Navarra
|September 24, 2004
PubMed
Summary
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Bariatric surgery is a key treatment for morbid obesity, requiring careful patient selection and assessment for best outcomes. It significantly improves obesity-related health issues, though lifelong follow-up is essential.

Area of Science:

  • Surgical Sciences
  • Obesity Medicine
  • Metabolic Surgery

Context:

  • Morbid obesity necessitates bariatric surgery, demanding strict selection criteria based on obesity degree, complications, and prior treatment failures.
  • Contraindications include substance addiction and severe concurrent diseases, necessitating thorough pre-operative evaluation for eating disorders and comorbidities like cardiovascular disease, sleep apnea, metabolic, and psychiatric conditions.

Purpose:

  • To outline the indications, contraindications, pre-operative assessments, surgical techniques, and outcomes of bariatric surgery for morbidly obese patients.

Summary:

  • Surgical techniques are categorized into restrictive (gastroplasty, adjustable gastric banding) and malabsorptive/mixed procedures (gastric bypass, biliopancreatic diversion, duodenal switch).
  • Mixed techniques are prevalent, with gastric bypass reducing excess weight by 60-70%, and biliopancreatic diversion/duodenal switch by 75%.

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Impact:

  • Bariatric surgery leads to significant improvements in associated comorbidities, including diabetes, hypertension, dyslipidemia, and sleep apnea.
  • Postoperative mortality is low (1-2%), with major risks including peritonitis and venous thromboembolism. Lifelong follow-up with nutritional planning and supplementation is crucial.