BMC Endocr Disord
July 2025
Introduction: Metabolic and bariatric surgery (MBS) has been an established treatment option for patients with Type 2 diabetes mellitus (T2DM), but there is a relative paucity of evidence-based guidelines on preoperative, operative, and postoperative considerations concerning metabolic surgery for T2DM patients. To address this gap, we initiated a Delphi consensus process with a diverse group of international multidisciplinary experts.
Method: We embarked on a Delphi consensus-building exercise to propose an evidence-based expert consensus covering various aspects of MBS in patients with T2DM.
Despite the growing popularity of one anastomosis gastric bypass (OAGB) as the third most commonly performed metabolic and bariatric surgery (MBS) procedure worldwide, concerns remain among MBS surgeons about performing OAGB in children and adolescents. This international expert survey was conducted to assess the perspectives of experts regarding the different aspects of OAGB specific to these patient groups. A total of 102 expert MBS surgeons from 41 countries were invited to participate in this survey, which took place between 24 May 2024, and 11 June 2024.
View Article and Find Full Text PDFArtificial intelligence (AI) is transforming the landscape of medicine, including surgical science and practice. The evolution of AI from rule-based systems to advanced machine learning and deep learning algorithms has opened new avenues for its application in metabolic and bariatric surgery (MBS). AI has the potential to enhance various aspects of MBS, including education and training, decision-making, procedure planning, cost and time efficiency, optimization of surgical techniques, outcome and complication prediction, patient education, and access to care.
View Article and Find Full Text PDFObes Surg
September 2024
Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.
Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds.
Purpose Of Review: Gastroparesis is a chronic disorder characterized by a constellation of foregut symptoms, including postprandial nausea, vomiting, distension, epigastric pain, and regurgitation in the absence of gastric outlet obstruction. Despite considerable research over the past decades, there remains to be only nominal understanding of disease classification, diagnostic criteria, pathogenesis, and preferred therapy.
Recent Findings: We critically reassess current approaches for disease identification and stratification, theories of causation, and treatment for gastroparesis.
MAJOR UPDATES TO 1991 NATIONAL INSTITUTES OF HEALTH GUIDELINES FOR BARIATRIC SURGERY: Metabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m.
View Article and Find Full Text PDFBackground: Hospital readmission (HR) rates following metabolic/bariatric surgery (MBS) are used as a surrogate for quality outcomes and are increasingly tied to reimbursement rates. There are limited data concerning predictors of HR rates with regard to type of bariatric procedure.
Methods: This study is a retrospective review of prospectively collected data from patients who underwent MBS from January 2014 to December 2019 at Brigham and Women's Hospital in Boston, Massachusetts.
Major updates to 1991 National Institutes of Health guidelines for bariatric surgery.
View Article and Find Full Text PDFIntroduction: Previous studies have demonstrated that one anastomosis gastric bypass (OAGB) is not inferior to Roux-en-Y gastric bypass (RYGB) in treating obesity. However, high level evidence comparing the efficacy and safety of both procedures in type 2 diabetes (T2D) treatment is still lacking, which is another main aim of bariatric surgery. The presented trial has been designed to aim at investigating the superiority of OAGB over the reference procedure RYGB in treating T2D as primary endpoint.
View Article and Find Full Text PDFBackground: Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons.
View Article and Find Full Text PDFBackground: Obesity is a risk factor for gallstone formation, which can be exacerbated by bariatric surgery-induced rapid weight loss. Current guidelines do not recommend concomitant cholecystectomy (CC) for asymptomatic gallstones during the bariatric surgery procedure. However, long-term follow-up studies have shown that the incidence of post-bariatric surgery symptomatic gallstones necessitating therapeutic cholecystectomy increases to 40%.
View Article and Find Full Text PDFSurg Endosc
December 2021
Introduction: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG.
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