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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2016; 70(6): 485–490. doi:10.14735/amgh2016485.

Recent bariatric-metabolic surgery

Pavol Holéczy  1,2, Marek Bužga  3

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Bariatric surgery has more than a 60-year long history. From its origin until now, many types of operations have been proposed and have met with success to a greater or lesser degree. Some have been abandoned, while others, albeit in modified formats, are still relevant today. Currently, bariatric surgery is gradually and slowly growing in popularity throughout the world, including in the Czech Republic. The operation rate is significantly increasing. Many publications have documented its fundamental and long-term effect on weight reduction. Recently, there has been a shift in attention away from the importance of surgical intervention in weight reduction to the impact of surgical intervention on comorbidities, especially type 2 diabetes mellitus. At present, three types of operations are most frequently performed: sleeve gastrectomy, gastric bypass and adjustable gastric banding. Each type of operation has distinct metabolic consequences and a different effect on gastrointestinal hormone levels, according to the extent to which it changes the digestive tract. The most significant hormonal effect of surgically-induced changes in the gastrointestinal tract is an improvement in insulin resistance. A new approach that defines the type of operation according to the objective has attracted considerable interest. The authors present a comprehensive overview of the most commonly performed operations in the world, including in the Czech Republic, as well as a comparative analysis of the metabolic effects of each type of  operation.


bariatric-metabolic surgery, type 2 diabetes mellitus, treatment of comorbidities, types of transactions

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