ABSTRACT
Introduction ............................................................................................................ 184 Indications .............................................................................................................. 185 Contraindications ................................................................................................... 186 Mechanisms of Weight Loss .................................................................................. 186 Preoperative Preparation ........................................................................................ 187 Types of Current Bariatric Surgery ........................................................................ 188
Gastric Bypass Surgery ..................................................................................... 188 Laparoscopic Adjustable Gastric Banding ........................................................ 189 Vertical Banded Gastroplasty ............................................................................ 190 Sleeve Gastrectomy ........................................................................................... 190 Biliopancreatic Diversion/Duodenal Switch ..................................................... 192 Jejunoileal Bypass ............................................................................................. 194
Outcomes and Effectiveness after Bariatric Surgery ............................................. 195 Mortality ................................................................................................................ 196 Postoperative Complications .................................................................................. 196
Anastomotic Leak ............................................................................................. 196 Bleeding ............................................................................................................ 197 Internal Hernia .................................................................................................. 197 Cardiovascular Complications .......................................................................... 197 Pulmonary Embolism and Other Pulmonary Complications ............................ 197 Wound Complications ....................................................................................... 198 Stomal Stenosis ................................................................................................. 198 Marginal Ulceration .......................................................................................... 198 Diarrhea/Constipation ....................................................................................... 199 Cholelithiasis ..................................................................................................... 199 Dumping Syndrome .......................................................................................... 199
Metabolic and Nutritional Derangements ..............................................................200 Protein Calorie Malnutrition .............................................................................200 Vitamin B12 ......................................................................................................200 Folate ................................................................................................................. 201 Thiamine ........................................................................................................... 201 Lipid-Soluble Vitamins ..................................................................................... 201
Weight loss surgery (referred to as “bariatric surgery”) has been used to treat severe obesity that has not responded to behavior modication, dietary therapy, exercise, and drug therapy. The word “bariatric” originates from a Greek word “baros” and “iatrikos” meaning “weight” and “medicine,” respectively. Bariatric surgery includes a variety of procedures, which are performed on those who are obese, for the purpose of losing weight and improving or resolving comorbidities. Currently, this surgery provides the greatest degree of sustained weight loss for obese patients.
