Effect of gastrointestinal surgical manipulation on metabolic syndrome: a focus on metabolic surgery

Mario Rizzello, Francesco De Angelis, Fabio Cesare Campanile, Gianfranco Silecchia, Mario Rizzello, Francesco De Angelis, Fabio Cesare Campanile, Gianfranco Silecchia

Abstract

Metabolic syndrome is strictly associated with morbid obesity and leads to an increased risk of cardiovascular diseases and related mortality. Bariatric surgery is considered an effective option for the management of these patients. We searched MEDLINE, Current Contents, and the Cochrane Library for papers published on bariatric surgery outcomes in English from 1 January 1990 to 20 July 2012. We reported the effect of gastrointestinal manipulation on metabolic syndrome after bariatric surgery. Bariatric surgery determines an important resolution rate of major obesity-related comorbidities. Roux-en-Y gastric bypass and biliopancreatic diversion appear to be more effective than adjustable gastric banding in terms of weight loss and comorbidities resolution. However, the results obtained in terms of weight loss and resolution of comorbidities after a "new bariatric procedure" (sleeve gastrectomy) encouraged and stimulated the diffusion of this operation.

Figures

Figure 1
Figure 1
Adjustable gastric banding.
Figure 2
Figure 2
Roux-en-Y gastric bypass.
Figure 3
Figure 3
Biliopancreatic diversion with duodenal switch.
Figure 4
Figure 4
Sleeve gastrectomy.
Figure 5
Figure 5
(a) Ileal interposition associated to sleeve gastrectomy. (b) Ileal interposition associated to diverted sleeve gastrectomy.
Figure 6
Figure 6
The EndoBarrier gastrointestinal liner. Food bypasses the duodenum and proximal jejunum as it does in a Roux-en-Y Gastric Bypass.
Figure 7
Figure 7
Anti-incretin theory.
Figure 8
Figure 8
Proposed model for mechanisms of T2DM resolution after bariatric surgery (simplified from [32]).

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Source: PubMed

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