ABSTRACT
Relatively healthy patients coming to elective surgery, usually from home, are not often malnourished. That said, patients with chronic conditions of the gastrointestinal (GI) tract whose underlying disease may be an obstacle to maintaining adequate nutrition are often malnourished, even if this is only subclinical; more extreme examples of this spectrum of GI disease are those where the impact of disease on nutrition in and of itself becomes an indication of surgery. While it is intuitive to view perioperative malnutrition as synonymous with undernutrition, it is important to recognize that nutritional excess as seen with morbid obesity, either as comorbidity or in the setting of bariatric surgery, poses an equal challenge. For the purpose of this chapter, we have deliberately not covered
Introduction .................................................................................................................................... 423 Physiology ......................................................................................................................................424 Surgical Anatomy ...........................................................................................................................424
