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European Surgery
Published in: European Surgery 1-2/2024

Open Access 30-10-2023 | DFP-Fortbildung

Bariatrisch-metabolische Operationstechniken

Mechanismus, Operationstechnik und perioperatives Management

Author: Dr. med. univ. Aline-Louise Schäfer

Published in: European Surgery | Issue 1-2/2024

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Zusammenfassung

Bariatrisch-metabolische Operationen gelten als die effektivste Therapiemöglichkeit der morbiden Adipositas. In Langzeitstudien konnten sehr gute Erfolge bei der Reduktion des Übergewichts und bei der Behandlung Adipositas-assoziierter Komorbiditäten (u. a. arterielle Hypertonie, Diabetes mellitus Typ 2) gezeigt werden. Die bariatrischen Operationstechniken beruhen auf dem Wirkungsprinzip der Restriktion und Malabsorption. Die damit verbundenen metabolischen Effekte, die z. T. unabhängig vom Gewichtsverlust und der Kalorienreduktion schon früh postoperativ einsetzen, werden derzeit intensiv beforscht. Die am häufigsten angewandten restriktiven Verfahren sind Schlauchmagen, Magenband, Magenfaltung und Magenballon. Beim Magenbypass, der biliopankreatischen Diversion (mit und ohne duodenalem Switch) und dem „single anastomosis duodenal-ileal-bypass“ mit Sleeve werden die Wirkprinzipien kombiniert. Die Eingriffe werden üblicherweise laparoskopisch durchgeführt und haben akzeptable Komplikationsraten. Postoperativ sind lebenslange Stoffwechselkontrollen und Substitution mit Vitaminen und Spurenelementen (insbesondere bei malabsorptiven Verfahren) erforderlich, um einer Malnutrition vorzubeugen.
Literature
1.
Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC. Probability of an obese person attaining normal body weight: cohort study using electronic health records. Am J Public Health. 2015;105(9):e54–9.CrossRefPubMedPubMedCentral
2.
Angrisani L, Santonicola A, Iovino P, Ramos A, Shikora S, Kow L. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021;31(5):1937–48.CrossRefPubMedPubMedCentral
3.
Kremen AJ, Linner JH, Nelson CH. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg. 1954;140(3):439–48.CrossRefPubMedPubMedCentral
4.
5.
Terra X, Auguet T, Guiu-Jurado E, Berlanga A, Orellana-Gavaldà JM, Hernández M, et al. Long-term changes in leptin, chemerin and ghrelin levels following different bariatric surgery procedures: Roux-en‑Y gastric bypass and sleeve gastrectomy. Obes Surg. 2013;23(11):1790–8.CrossRefPubMed
6.
O’Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-term outcomes after Bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all Bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2019;29(1):3–14.CrossRefPubMed
7.
Kothari SN, Borgert AJ, Kallies KJ, Baker MT, Grover BT. Long-term (〉 10-year) outcomes after laparoscopic Roux-en‑Y gastric bypass. Surg Obes Relat Dis. 2017;13(6):972–8.CrossRefPubMed
8.
Felsenreich DM, Langer FB, Eichelter J, Jedamzik J, Gensthaler L, Nixdorf L, et al. Bariatric surgery-how much malabsorption do we need?—A review of various limb lengths in different gastric bypass procedures. J Clin Med. 2021;10(4):674.CrossRefPubMedPubMedCentral
9.
Topart P, Becouarn G, Ritz P. Should biliopancreatic diversion with duodenal switch be done as single-stage procedure in patients with BMI > or = 50 kg/m2? Surg Obes Relat Dis. 2010;6(1):59–63.CrossRefPubMed
10.
Benaiges D, Más-Lorenzo A, Goday A, Ramon JM, Chillarón JJ, Pedro-Botet J, et al. Laparoscopic sleeve gastrectomy: more than a restrictive bariatric surgery procedure? World J Gastroenterol. 2015;21(41):11804–14.CrossRefPubMedPubMedCentral
11.
Felsenreich DM, Kefurt R, Schermann M, Beckerhinn P, Kristo I, Krebs M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;27(12):3092–101.CrossRefPubMed
12.
Bruzzi M, Chevallier J‑M, Czernichow S. One-anastomosis gastric bypass: why biliary reflux remains controversial? Obes Surg. 2017;27(2):545–7.CrossRefPubMed
13.
Conversion of One Anastomosis Gastric Bypass (OAGB) to Roux-en‑Y Gastric Bypass (RYGB) for Biliary Reflux Resistant to Medical Treatment: Lessons Learned from a Retrospective Series of 2780 Consecutive Patients Undergoing OAGB. https://​pubmed.​ncbi.​nlm.​nih.​gov/​32052289/​. Zugegriffen: 6. Okt. 2021.
14.
Furbetta N, Cervelli R, Furbetta F. Laparoscopic adjustable gastric banding, the past, the present and the future. Ann Transl Med. 2020;8(Suppl 1):S4.CrossRefPubMedPubMedCentral
15.
Abdelbaki TN, Huang C‑K, Ramos A, Neto MG, Talebpour M, Saber AA. Gastric plication for morbid obesity: a systematic review. Obes Surg. 2012;22(10):1633–9.CrossRefPubMed
16.
17.
Saber AA, Shoar S, Almadani MW, Zundel N, Alkuwari MJ, Bashah MM, et al. Efficacy of first-time Intragastric balloon in weight loss: a systematic review and meta-analysis of randomized controlled trials. Obes Surg. 2017;27(2):277–87.CrossRefPubMed
18.
19.
Imaz I, Martínez-Cervell C, García-Alvarez EE, Sendra-Gutiérrez JM, González-Enríquez J. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18(7):841–6.CrossRefPubMed
20.
Scopinaro N, Adami GF, Marinari GM, Gianetta E, Traverso E, Friedman D, et al. Biliopancreatic diversion. World J Surg. 1998;22(9):936–46.CrossRefPubMed
21.
Bianchi A, Pagan-Pomar A, Jimenez-Segovia M, Martinez-Corcoles JA, Gonzalez-Argenté FX. Biliopancreatic diversion in the surgical treatment of morbid obesity: long-term results and metabolic consequences. Obes Surg. 2020;30(11):4234–42.CrossRefPubMed
22.
Topart P, Becouarn G, Sallé A, Ritz P. Biliopancreatic diversion requires multiple vitamin and micronutrient adjustments within 2 years of surgery. Surg Obes Relat Dis. 2014;10(5):936–41.CrossRefPubMed
23.
Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8(3):267–82.CrossRefPubMed
24.
25.
Surve A, Cottam D, Medlin W, Richards C, Belnap L, Horsley B, et al. Long-term outcomes of primary single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Surg Obes Relat Dis. 2020;16(11):1638–46.CrossRefPubMed
26.
Spinos D, Skarentzos K, Esagian SM, Seymour KA, Economopoulos KP. The effectiveness of single-anastomosis duodenoileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS): an updated systematic review. Obes Surg. 2021;31(4):1790–800.CrossRefPubMed
27.
Kermansaravi M, Shahmiri SS, Davarpanah Jazi AH, Valizadeh R, Berardi G, Vitiello A, et al. One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive Bariatric procedures: a systematic review and meta-analysis. Obes Surg. 2021;31(1):370–83.CrossRefPubMed
28.
Schäfer A, Gehwolf P, Umlauft J, Dziodzio T, Biebl M, Perathoner A, et al. Revisional gastric bypass after failed adjustable gastric banding-one-stage or two-stage procedure? Obes Surg. 2019;29(3):943–8.CrossRefPubMed
29.
Bal BS, Finelli FC, Shope TR, Koch TR. Nutritional deficiencies after bariatric surgery. Nat Rev Endocrinol. 2012;8(9):544–56.CrossRefPubMed
30.
31.
Coblijn UK, Goucham AB, Lagarde SM, Kuiken SD, van Wagensveld BA. Development of ulcer disease after Roux-en‑Y gastric bypass, incidence, risk factors, and patient presentation: a systematic review. Obes Surg. 2014;24(2):299–309.CrossRefPubMed
32.
Carr WRJ, Mahawar KK, Balupuri S, Small PK. An evidence-based algorithm for the management of marginal ulcers following Roux-en‑Y gastric bypass. Obes Surg. 2014;24(9):1520–7.CrossRefPubMed
33.
Almby K, Edholm D. Anastomotic strictures after Roux-en‑Y gastric bypass: a cohort study from the Scandinavian obesity surgery registry. Obes Surg. 2019;29(1):172–7.CrossRefPubMed
34.
Contival N, Menahem B, Gautier T, Le Roux Y, Alves A. Guiding the non-bariatric surgeon through complications of bariatric surgery. J Visc Surg. 2018;155(1):27–40.CrossRefPubMed
35.
Alizadeh RF, Li S, Inaba C, Penalosa P, Hinojosa MW, Smith BR, et al. Risk factors for gastrointestinal leak after Bariatric surgery: MBASQIP analysis. J Am Coll Surg. 2018;227(1):135–41.CrossRefPubMed
36.
Csendes A, Burgos AM, Braghetto I. Classification and management of leaks after gastric bypass for patients with morbid obesity: a prospective study of 60 patients. Obes Surg. 2012;22(6):855–62.CrossRefPubMed
37.
van Berckel MMG, Ederveen JC, Nederend J, Nienhuijs SW. Internal herniation and weight loss in patients after Roux-en‑Y gastric bypass. Obes Surg. 2020;30(7):2652–8.CrossRefPubMed
38.
Cho M, Pinto D, Carrodeguas L, Lascano C, Soto F, Whipple O, et al. Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en‑Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: review of 1400 consecutive cases. Surg Obes Relat Dis. 2006;2(2):87–91.CrossRefPubMed
39.
Guzman-Pruneda FA, Brethauer SA. Gastroesophageal reflux after sleeve gastrectomy. J Gastrointest Surg. 2021;25(2):542–50.CrossRefPubMed
40.
Mittermair RP, Obermüller S, Perathoner A, Sieb M, Aigner F, Margreiter R. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19(12):1636–41.CrossRefPubMed
41.
Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-Bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.CrossRefPubMed
42.
Gazda CL, Clark JD, Lingvay I, Almandoz JP. Pharmacotherapies for post-Bariatric weight regain: real-world comparative outcomes. Obesity. 2021;29(5):829–36.CrossRefPubMed
43.
Metadata
Title
Bariatrisch-metabolische Operationstechniken
Mechanismus, Operationstechnik und perioperatives Management
Author
Dr. med. univ. Aline-Louise Schäfer
Publication date
30-10-2023
Publisher
Springer Vienna
Published in
European Surgery / Issue 1-2/2024
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-023-00811-0

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