What is bariatric surgery?
Bariatric surgery includes a type of surgery used in obese patients. Examples include gastric sleeve resection, biliopancreatic bypass, and gastric bypass surgery, which reduces the volume of the stomach by means of a gastric band (adjustable gastric banding) or by removing a portion of the stomach.
What are the methods of bariatric surgery?
Common procedures include.
Laparoscopic adjustable gastric banding (LAGB laparoscopic adjustable gastric banding) A
Laparoscopic sleeve gastrectomy (LSG laparoscopic sleeve gastrectomy) B
Roux-en-Y shunt Roux-en-Y gastric bypass c
Bilopancreatic diversion with duodenal switch D
What are the advantages of bariatric surgery?
1.Weight reduction: obvious effect
2.Improve metabolic index.
The gastrointestinal tract is not only the main component of the digestive system, but also the largest “endocrine organ” in the body, regulating the secretory function of the islets and the dynamic balance of cell proliferation and apoptosis through the endocrine hormone feedback mechanism. Metabolic surgery changes the dynamic balance of hormones in the gastrointestinal tract by altering food flow, and restarts the endogenous islet endocrine function regulation mechanism through the intestinal-islet axis. After metabolic surgery, gastrointestinal hormones in the body are mainly expressed by enteroglucagon, which improves the role of gastrointestinal hormones in regulating islet function, induces islet cell proliferation, regeneration and proliferation, and ultimately improves islet function, and diabetic patients are clinically treated.
What is BMI? How to calculate my own BMI?
BMI is the abbreviation of body mass index, also known as body mass index. It is a number derived by dividing weight in kilograms by height in meters squared, and is a common international measure of how fat or thin the body is and whether it is healthy.
Body mass index (BMI) = weight (kg kg) รท height2 (m m2)
For a person with a height of 160 cm and a weight of 90 kg
BMI = 90/(1.6)2 = 35.16kg/m2
What is the standard BMI range?
For Asian people, a BMI of 18.5-22.9 kg/m2 is the normal range.
What kind of patients cannot be treated with metabolic surgery for diabetes?
1. Patients with drug or alcohol addiction or mental illness that is difficult to control and patients who lack the ability to understand the risks, benefits and expected consequences of metabolic surgery.
2.Patients who are clearly diagnosed with type 1 diabetes
3.Patients with type 2 diabetes whose pancreatic islet beta cell function has been largely lost
4.Patients with combined bleeding and coagulation abnormal diseases and cardiopulmonary function that cannot tolerate the surgery
5.Diabetic patients with BMI <28kg/m2 and whose blood glucose can be satisfactorily controlled by medication and insulin.
6.Gestational diabetes and other special types of diabetes are temporarily excluded from the scope of surgical treatment.
What are the risks of bariatric surgery?
Recent postoperative complications.
Incisional infection
Intestinal obstruction: the risk fluctuates from procedure to procedure, the main causes are intestinal adhesions, intra-abdominal hernia, intussusception, etc.
Anastomotic leak
pulmonary embolism
Deep vein thrombosis: prone to moderate obesity, especially in those who lack preoperative exercise
Portal vein injury: rare
Respiratory complications
Long-term postoperative complications.
Digestive disorders: gallstone formation (due to excessive weight loss); gastroparesis; dumping syndrome
Malnutrition: can occur after any kind of bariatric surgery and should be guided by a dietitian after surgery and followed up for life
1.Iron deficiency anemia Folic acid deficiency
2. Vitamin B12 deficiency
3. Calcium and vitamin D deficiency
How is the management of metabolic surgery performed?
Preoperative screening and evaluation: diabetic patients with poor medical outcomes Screening
Surgery: experienced gastrointestinal surgeon in general surgery practice
Post-operative follow-up: surgeon + endocrinologist + dietitian team Lifetime follow-up