What is Bariatric Surgery?
Bariatric surgery, also known as obesity surgery, refers to a series of medical treatments for severely obese humans with the goal of losing weight.
Bariatric surgery
Bariatric surgery, also known as obesity surgery, refers to a series of medical treatments for severely obese humans with the goal of losing weight.
United States
National Institutes of Health
Humanity
Patients undergoing weight loss and diabetic surgery require life-long follow-up: in the first year after surgery, at least 4 outpatient follow-ups, as well as follow-up calls by phone or other means. The main contents of the follow-up included the patient's blood glucose, glycated hemoglobin, insulin, C peptide, as well as the patient's weight, nutritional status, and mental status.
Your doctor can keep track of your diabetes control, determine if you need diet or medication for adjuvant treatment, monitor if you have diabetes-related complications, and see if they improve after surgery. At the same time, the doctor can monitor you for surgical complications and lack of nutrients, vitamins or minerals to make treatment adjustments. If you experience any discomfort after surgery, your doctor will take action based on your situation.
Dietary guidance: New dietary habits need to be formed after surgery to promote and maintain the improvement of glucose metabolism, and at the same time can supplement the necessary nutrients to avoid discomfort.
Low-sugar, low-fat diet
Avoid overeating
Eat slowly, about 20-30 minutes per meal
Chew slowly and avoid too hard or large food
Eat protein-rich foods first, 60-80 g / day is recommended, avoid high-calorie foods
Depending on the surgical method, some need to be supplemented with essential vitamins daily, and supplemented with minerals and trace elements according to the instructions
Ensure sufficient daily fluid intake, not less than 2000mL is recommended to avoid carbonated drinks
Studies have shown that patients undergoing weight loss compared with patients undergoing diabetic surgery who were treated only with traditional medications were able to completely relieve blood sugar in patients with type 2 diabetes. Two years after receiving gastric bypass, the patient's diabetes remission rate was 75%.
Definition of diabetes remission: glycated hemoglobin <6.5% without medication
In addition, weight loss and diabetes surgery can significantly resolve or improve type 2 diabetes and other obesity complications. Studies have shown that 86% of patients with weight loss and diabetes surgery can resolve or improve diabetes, 70% or more of those with high blood lipids, 78.5% of those with hypertension or high blood pressure, and Hun En can resolve sleep 85.7% of patients with apnea
While controlling blood sugar, undergoing weight loss and diabetes surgery can also reduce the use of drugs such as diabetes, hypertension, and hyperlipidemia, which can affect patients' overall health, emotional health, physical and social functions, pain relief, and personal energy recovery. There are different degrees of improvement.
After the bariatric surgery, the patient can only eat liquid food until the patient's digestive tract is fully restored. In the next step, patients will switch to semi-liquid or completely sugar-free foods, which can be skimmed milk, oatmeal, protein drinks or fruit purees. After two weeks, you can switch to a normal diet.
Efficacy of bariatric surgery | Lose weight | Statistical period |
Gastric bypass | 41 kg | 2 years |
Gastric band | 35 kg | 2 years |
Stomach reduction | 32 kg | 2 years |
Gastric water polo | 22 kg | 6 months |
Further mid-term follow-up studies (3-8 years) and long-term follow-up studies (10 years) have shown that the long-term efficacy of various bariatric surgery tends to be very similar, and the long-term weight of all patients tends to range from BMI23-25. However, the excessive weight loss (BMI below 20) of gastric bypass surgery is greater than other surgery. A 10-year follow-up study of gastric reduction surgery is not yet complete (as of December 2009).
Several recent studies have shown that bariatric surgery reduces long-term mortality and greatly improves the quality of life for patients and their families.
The Swedish National Institutes of Health's follow-up study of patients with BMI 34 to 38 after undergoing bariatric surgery for 11 years showed a reduction of 23.7% in patient mortality. (5% death rate after weight loss surgery; 6.3% death rate in the control group) A University of Utah study also showed that the 7-year mortality rate after weight loss surgery was 0.4%; the control group was 0.6%. The conclusion is similar to the Swedish study. The above studies are aimed at normal causes of death, such as diabetes, heart disease, and cancer. If combined with the cause of accidental death, such as accidents and suicide, the overall mortality rate of patients after weight loss surgery is reduced by 58%.
Argentina star: Maradona, who received the weight loss treatment of the famous doctor Xeno in Bali, Italy in 2005,
Due to the special growth stages of adolescents, gastric reduction surgery and gastric bypass surgery are not suitable for adolescents unless severe obesity immediately endangers the patient's life. Adolescents may consider undergoing adjustable gastric band surgery. The recommended bariatric surgery for teenagers is easy-to-recover intragastric water polo.
Complications of bariatric surgery are frequent. U.S. health insurance data show that of 2,522 patients, 21.9% of patients had a certain complication during their stay in the hospital, and within the next 6 months, the chance of complication reached 40%. Complications are more common in patients over 40 years of age. The most common complications are listed below:
Leak at surgery | 12% |
infection | 6% |
Pneumonia | 4% |
mortality rate | 0.2% |
By skilled
The course of type 2 diabetes is 15 years, and the islet still has a certain insulin secretion function. The fasting serum C peptide level is 2/1 of the lower limit of normal value.
BMI27.5kg / m²
When the waist circumference of men is 90cm, and the waist circumference of women is 85cm, the recommended surgery level can be increased as appropriate
Recommended age 16-65
Patients with BMI between 25.0-27.4kg / m² need to consider surgery carefully
The above standards, doctors also need to consider the patient's metabolic syndrome components or the existence of comorbidities, please consult the doctor in detail
Patients with a clear diagnosis of non-obese type 1 diabetes
Patients with T2DM who have basically lost islet -cell function, low serum C-peptide levels, or low C-peptide release profiles under glucose load
Surgery is not recommended for patients with BMI <25kg / m²
Gestational diabetes and some special types of diabetes
Patients with drug or alcohol addiction or with uncontrollable mental illness
Patients with mental retardation or mental immature who cannot control their behavior
Patients whose expectations for surgery are not realistic
Patients unwilling to bear the risk of potential complications from surgery
Patients who cannot cope with changes in diet and lifestyle after surgery, and patients with poor compliance
Patients with poor general conditions who cannot tolerate general anesthesia or surgery
Modern surgical techniques have been able to minimize complications. There is a certain misunderstanding of the risk of weight loss and diabetes surgery. The risk of surgery is not as high as expected. In fact, mortality from weight loss and diabetic surgery has proven to be lower than other common procedures, such as cholecystectomy.
