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Gastric bypass and its role in metabolic and bariatric surgery

Česká verzia

Authors: M. Čierny ;  A. Trávniček;  J. Ucháľ
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 2, s. 58-63.
Category: Original articles

Summary

Introduction:

Historically, gastric bypass (GB) has been the oldest procedure used in bariatric surgery. Even though technically demanding, it had been the most widely used method for decades worldwide and still holds an irreplaceable position for its pronounced and long-term metabolic effect as well as for the therapeutic effect in gastroesophageal reflux (GERD).

Method:

The authors retrospectively analyse a series of 268 cases of GB, focusing on short-term weight loss, the metabolic effect on type two diabetes (T2DM), complication and reoperation rates and the BAROS scoring system in Roux-en-Y bypass (RYGB) and in minigastric bypass with one anastomosis (MGB/OAGB), comparing both of them to more frequently used gastric plication and sleeve gastrectomy.

Results:

Both GB, without any increase in complication and reoperation rates, lead to a higher weight loss and the best BAROS scoring in comparison to other, simpler restrictive procedures. One year after GB, resolution of T2DM is seen in most diabetes patients operated on, the number needed to treat being <2.

Conclusion:

GB are safe and effective in short term and later, more than two years after surgery, show an excellent result according to the BAROS scoring. Excellent outcomes are reached particularly in compliant patients with T2DM, with GERD and in reoperations. In most diabetes patients, the unique metabolic effect of GB results in remission of otherwise incurable T2DM and significantly changes the position of surgery within diabetology. The authors call for a systematic nationwide evidence of long-term results in MB surgery and for conceptual development of surgical treatment of T2DM in centers of MB surgery.

Keywords:

bariatric and metabolic surgery – gastric bypass – type – surgical treatment of diabetes

Zdroje
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Štítky
Surgery Orthopaedics Trauma surgery
Článek The present and future of metabolic surgery
Článek Bariatric/metabolic surgery: the diabetologist’s view
Článek SADIS − Single anastomosis duodeno-ileal bypass with sleeve gastrectomy as a second step after sleeve gastrectomy
Článek Wernicke´s encephalopathy as rare complication after sleeve gastrectomy
Článek Partial magnetic jejunal diversion (PMJD) in severely obese patients
Článek Unusual complications after bariatric surgery − gastric plication
Článok vyšiel v časopise

Perspectives in Surgery

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2019 Číslo 2
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