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Publication
Recent advances in metabolic and bariatric surgery.
Authors Albaugh VL, Flynn CR, Tamboli RA, Abumrad NN
Submitted By Submitted Externally on 5/17/2017
Status Published
Journal F1000Research
Year 2016
Date Published
Volume : Pages 5 : Not Specified
PubMed Reference 27239296
Abstract Obesity and its associated medical conditions continue to increase and add
significant burden to patients, as well as health-care systems, worldwide.
Bariatric surgery is the most effective treatment for severe obesity and its
comorbidities, and resolution of diabetes is weight loss-independent in the case
of some operations. Although these weight-independent effects are frequently
described clinically, the mechanisms behind them are not well understood and
remain an intense area of focus in the growing field of metabolic and bariatric
surgery. Perceptions of the mechanisms responsible for the beneficial metabolic
effects of metabolic/bariatric operations have shifted from being mostly
restrictive and malabsorption over the last 10 to 15 years to being more
neuro-hormonal in origin. In this review, we describe recent basic and clinical
findings of the major clinical procedures (adjustable gastric banding, vertical
sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion) as
well as other experimental procedures (ileal interposition and bile diversion)
that recapitulate many of the metabolic effects of these complex operations in a
simpler fashion. As the role of bile acids and the gut microbiome on metabolism
is becoming increasingly well described, their potential roles in these
improvements following metabolic surgery are becoming better appreciated. Bile
acid and gut microbiome changes, in light of recent developments, are discussed
in the context of these surgical procedures, as well as their implications for
future study.




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