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An international Delphi consensus on patient preparation for metabolic and bariatric surgery

DR. Clyde, R. Adib, S. Baig, AG. Bhasker, J. Byrne, D. Cameron, C. Catalain, K. Clare, A. de Beaux, G. Drummond, H. Fawal, M. Fried, O. Ghanem, Y. Graham, R. Goel, G. Hopkins, F. Husain, B. Joyce, M. Kermansaravi, S. Kothari, L. Kow, S. Leite, B....

. 2025 ; 15 (2) : e12722. [pub] 20241214

Language English Country England, Great Britain

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc25009383

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m2), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources. Updated in 2022, ASMBS and IFSO guidelines aim to standardise MBS indications, reflecting current understanding and emphasising comprehensive preoperative assessments. Yet, clinical variability persists, necessitating consensus-based recommendations. This modified Delphi study engaged 45 global experts to establish consensus on perioperative management in MBS. Experts selected from bariatric societies possessed expertise in MBS and participated in a two-round Delphi protocol. Consensus was achieved on 90 of 169 statements (53.3%), encompassing multidisciplinary team composition, patient selection criteria, preoperative testing, and referral pathways. The agreement highlighted the critical role of comprehensive preoperative assessments and the integration of healthcare professionals in MBS. These findings offer essential insights to standardise perioperative practices and advocate for evidence-based guidelines in MBS globally. The study underscores the need for unified protocols to optimise outcomes and guide future research in MBS.

ABC Medical Center Mexico City Mexico

Brigham and Women's Hospital Boston USA

Clínica Anglo American Lima Peru

Clinical Department of Surgery University of Edinburgh Edinburgh UK

Department of Metabolic and Bariatric Surgery The 1st Affiliated Hospital of Jinan University Guangzhou China

Digestive Surgery Clinic Kolkata India

Faculty of Biology and Medicine University of Lausanne Switzerland

Flinders Medical Centre Adelaide Australia

Harvard Medical School Boston USA

Hazrat e Fatemeh Hospital School of Medicine Iran University of Medical Sciences Tehran Iran

Hospital Vall de Hebron Barcelona Spain

Imperial College London London UK

Jersey General Hospital Jersey

Leeds Beckett University Leeds UK

Leeds Teaching Hospitals NHS Trust Leeds UK

Makassed General Hospital Beirut Lebanon

Massachusetts General Hospital Weight Center Boston USA

Mayo Clinic Rochester Minnesota USA

Mediclinic Airport Road Hospital Abu Dhabi UAE

MetaHeal Laparoscopy and Bariatric Surgery Center Mumbai India

Mid Yorkshire Teaching Trust UK

OB Klinika Prague Czech Republic

Örebro University Örebro Sweden

Orlando Health Weight Loss and Bariatric Surgery Institute Florida USA

Ponderas Academic Hospital Bucharest Romania

Prisma Health Greenville USA

Riviera Chablais Hospital Rennaz Switzerland

Royal Brisbane and Women's Hospital Brisbane Australia

Royal Infirmary of Edinburgh Edinburgh UK

Somerset NHS Foundation Trust Somerset UK

South Tyneside and Sunderland NHS Health Trust UK

Southampton General Hospital Southampton UK

St Clara and University Hospital Basel Switzerland

Sunway Medical Centre Penang Malaysia

University College London London UK

University Hospitals of Derby and Burton NHS Foundation Trust

University of Arizona College of Medicine Phoenix USA

University of Birmingham Birmingham UK

University of Brasilia DF Brazil

University of Innsbruck Austria

University of Sunderland Sunderland UK

University of Turku Turku University Hospital Turku Finland

Wesley Hospital Brisbane Australia

West Hertfordshire Teaching Hospitals NHS Trust UK

Whittington Hospital London UK

Wockhardt Hospital Mumbai India

References provided by Crossref.org

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$a Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m2), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources. Updated in 2022, ASMBS and IFSO guidelines aim to standardise MBS indications, reflecting current understanding and emphasising comprehensive preoperative assessments. Yet, clinical variability persists, necessitating consensus-based recommendations. This modified Delphi study engaged 45 global experts to establish consensus on perioperative management in MBS. Experts selected from bariatric societies possessed expertise in MBS and participated in a two-round Delphi protocol. Consensus was achieved on 90 of 169 statements (53.3%), encompassing multidisciplinary team composition, patient selection criteria, preoperative testing, and referral pathways. The agreement highlighted the critical role of comprehensive preoperative assessments and the integration of healthcare professionals in MBS. These findings offer essential insights to standardise perioperative practices and advocate for evidence-based guidelines in MBS globally. The study underscores the need for unified protocols to optimise outcomes and guide future research in MBS.
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