BACKGROUND: Surgery for obesity and metabolic diseases has been evolved in the light of new scientific evidence, long-term outcomes and accumulated experience. EAES has sponsored an update of previous guidelines on bariatric surgery. METHODS: A multidisciplinary group of bariatric surgeons, obesity physicians, nutritional experts, psychologists, anesthetists and a patient representative comprised the guideline development panel. Development and reporting conformed to GRADE guidelines and AGREE II standards. RESULTS: Systematic review of databases, record selection, data extraction and synthesis, evidence appraisal and evidence-to-decision frameworks were developed for 42 key questions in the domains Indication; Preoperative work-up; Perioperative management; Non-bypass, bypass and one-anastomosis procedures; Revisional surgery; Postoperative care; and Investigational procedures. A total of 36 recommendations and position statements were formed through a modified Delphi procedure. CONCLUSION: This document summarizes the latest evidence on bariatric surgery through state-of-the art guideline development, aiming to facilitate evidence-based clinical decisions.

Biomedical Research Centre National Institute of Health Research London UK

Center for Treatment of Obesity and Metabolic Disorders OB Klinika Prague Czech Republic

Centre for Obesity Research University College London London UK

Department of Anesthesiology Ponderas Academic Hospital Regina Maria Bucharest Romania

Department of Endocrine and Metabolic Surgery University of Insubria Ospedale di Circolo and Fondazione Macchi ASST Sette Laghi Varese Italy

Department of General Surgery Ponderas Academic Hospital Regina Maria Bucharest Romania

Department of General Surgery ULSS5 del Veneto Adria Italy

Department of General Surgery Yeovil District Hospital NHS Foundation Trust Yeovil UK

Department of Internal Medicine D Hasharon Hospital Rabin Medical Center Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Department of Medical Surgical Sciences and Biotechnologies Faculty of Pharmacy and Medicine La Sapienza University of Rome Polo Pontino Bariatric Centre of Excellence IFSO EC Via F Faggiana 1668 04100 Latina Italy

Department of Psychological Sciences Institute of Psychology Health and Society University of Liverpool Liverpool UK

Department of Surgery C Chaim Sheba Medical Center Ramat Gan Israel

Department of Surgery European University of Cyprus Nicosia Cyprus

Department of Surgery Maastricht University Medical Centre Maastricht The Netherlands

Department of Surgery Mediterranean Hospital of Cyprus Limassol Cyprus

Department of Surgical Sciences University of Rome Tor Vergata Rome Italy

Division of General Surgery Castelfranco and Montebelluna Hospitals Treviso Italy

Division of General Surgery Department of Surgery Vienna Medical University Vienna Austria

Emergency Department General Hospital of Attica KAT Athens Greece

Endocrine Metabolic and Bariatric Unit General Surgery Department Vall D'Hebron University Hospital Center of Excellence for the EAC BC Universitat Autònoma de Barcelona Barcelona Spain

General Surgery Department Consorci Sanitari de L'Anoia Barcelona Spain

Herzliya Medical Center Herzliya Israel

Hospital Sant Pau UAB Barcelona Spain

Internal Medicine 3 Department of Medicine DIMED Center for the Study and the Integrated Treatment of Obesity University Hospital of Padua Padua Italy

Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Unit of Innovation in Minimally Invasive Surgery Department of General and Digestive Surgery University Hospital Virgen del Rocío 41010 Sevilla Spain

VU Amsterdam Amsterdam Netherlands

Zobrazit více v PubMed

Qasim A, Turcotte M, de Souza RJ, et al. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. Obes Rev. 2018 doi: 10.1111/obr.12625. PubMed DOI

WHO (2012) WHO obesity and overweight. World Heal Organ Media Cent Fact Sheet No 311

Grundy SM, Barondess JA, Bellegie NJ, et al. Gastrointestinal surgery for severe obesity. Ann Intern Med. 1991 doi: 10.7326/0003-4819-115-12-956. DOI

Sauerland S, Angrisani L, Belachew M, et al. Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES) Surg Endosc Other Interv Tech. 2005 doi: 10.1007/s00464-004-9194-1. PubMed DOI

SAGES SAGES guideline for clinical application of laparoscopic bariatric surgery. Surg Obes Relat Dis. 2009 doi: 10.1016/j.soard.2009.01.010. PubMed DOI

Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines on surgery of severe obesity. Obes Facts. 2008 doi: 10.1159/000113937. PubMed DOI PMC

Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European Guidelines on metabolic and bariatric surgery. Gastroenterol Hepatol. 2017 doi: 10.14735/amgh2017487. PubMed DOI

Pollack A (2019) A.M.A. Recognizes obesity as a disease—The New York Times. The New York Times.

Schünemann H, Brożek J, Guyatt G, Oxman A (2009) GRADE handbook for grading quality of evidence and strength of recommendations. The GRADE Working Group. PubMed

Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. J Clin Epidemiol. 2010;63(12):1308–1311. doi: 10.1016/j.jclinepi.2010.07.001. PubMed DOI

Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009 doi: 10.1016/j.jclinepi.2009.06.006. PubMed DOI

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GDRD (2000) MOOSE guidelines for meta-analyses and systematic reviews of observational studies. JAMA

Norris SL, Meerpohl JJ, Akl EA, Schünemann HJ, Chen Y, Whittington C. The skills and experience of GRADE methodologists can be assessed with a simple tool. J Clin Epidemiol. 2016 doi: 10.1016/j.jclinepi.2016.07.001. PubMed DOI

Akl EA, Lang D, Jaeschke R, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2008;2009:669–677. doi: 10.1111/j.1398-9995.2009.01973.x. PubMed DOI

Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011 doi: 10.1136/bmj.d5928. PubMed DOI PMC

Sterne J, Hernán M, Reeves B, et al (2016) Risk of bias in non-randomized studies of interventions (ROBINS-I): detailed guidance. BMJ

Schünemann HJ, Brozek J, Guyatt GH, Oxman AD (2013) Summarizing the evidence. In: GRADE handbook. https://gdt.gradepro.org/app/handbook/handbook.html

Schünemann HJ, Brozek J, Guyatt GH, Oxman AD (2013) Quality of evidence. GRADE handbook. https://gdt.gradepro.org/app/handbook/handbook.html

Schünemann HJ, Brozek J, Guyatt GH, Oxman AD (2013) Going from evidence to recommendations. GRADE handbook. https://gdt.gradepro.org/app/handbook/handbook.html PubMed

GRADE Working Group (2015) GRADEpro guideline development tool [software]. McMaster Univ

O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program. Ann Intern Med. 2006;144(9):625. doi: 10.7326/0003-4819-144-9-200605020-00005. PubMed DOI

Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes. JAMA. 2008 doi: 10.1001/jama.299.3.316. PubMed DOI

Liang Z, Wu Q, Chen B, Yu P, Zhao H, Ouyang X. Effect of laparoscopic Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus with hypertension: a randomized controlled trial. Diabetes Res Clin Pract. 2013;101(1):50–56. doi: 10.1016/j.diabres.2013.04.005. PubMed DOI

Wentworth JM, Playfair J, Laurie C, et al. Multidisciplinary diabetes care with and without bariatric surgery in overweight people: a randomised controlled trial. Lancet Diabetes Endocrinol. 2014;2(7):545–552. doi: 10.1016/S2213-8587(14)70066-X. PubMed DOI

Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–1576. doi: 10.1056/NEJMoa1200225. PubMed DOI PMC

Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017;376(7):641–651. doi: 10.1056/NEJMoa1600869. PubMed DOI PMC

Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–1585. doi: 10.1056/NEJMoa1200111. PubMed DOI

Ikramuddin S, Billington CJ, Lee W-J, et al. Roux-en-Y gastric bypass for diabetes (the diabetes surgery study): 2-year outcomes of a 5-year, randomised, controlled trial. Lancet Diabetes Endocrinol. 2015;3(6):413–422. doi: 10.1016/S2213-8587(15)00089-3. PubMed DOI PMC

Ikramuddin S, Korner J, Lee W-J, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia. JAMA. 2013;309(21):2240. doi: 10.1001/jama.2013.5835. PubMed DOI PMC

Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964–973. doi: 10.1016/S0140-6736(15)00075-6. PubMed DOI

Courcoulas AP, Goodpaster BH, Eagleton JK, et al. Surgical vs medical treatments for type 2 diabetes mellitus. JAMA Surg. 2014;149(7):707. doi: 10.1001/jamasurg.2014.467. PubMed DOI PMC

Halperin F, Ding S-A, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes. JAMA Surg. 2014;149(7):716. doi: 10.1001/jamasurg.2014.514. PubMed DOI PMC

Ding S-A, Simonson DC, Wewalka M, et al. Adjustable gastric band surgery or medical management in patients with type 2 diabetes: a randomized clinical trial. J Clin Endocrinol Metab. 2015;100(7):2546–2556. doi: 10.1210/jc.2015-1443. PubMed DOI PMC

Parikh M, Chung M, Sheth S, et al. Randomized pilot trial of bariatric surgery versus intensive medical weight management on diabetes remission in type 2 diabetic patients who do not meet NIH criteria for surgery and the role of soluble RAGE as a novel biomarker of success. Ann Surg. 2014;260(4):617–624. doi: 10.1097/SLA.0000000000000919. PubMed DOI PMC

Cummings DE, Arterburn DE, Westbrook EO, et al. Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia. 2016;59(5):945–953. doi: 10.1007/s00125-016-3903-x. PubMed DOI PMC

Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial: a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013 doi: 10.1111/joim.12012. PubMed DOI

Smelt HJM, Smulders JF, Gilissen LPL, Said M, Ugale S, Pouwels S. Influence of Helicobacter pylori infection on gastrointestinal symptoms and complications in bariatric surgery patients: a review and meta-analysis. Surg Obes Relat Dis. 2018 doi: 10.1016/j.soard.2018.06.020. PubMed DOI

Mocanu V, Dang JT, Switzer N, et al. The effect of helicobacter pylori on postoperative outcomes in patients undergoing bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2018 doi: 10.1007/s11695-017-3024-8. PubMed DOI

Schulman AR, Abougergi MS, Thompson CCH. Pylori as a predictor of marginal ulceration: a nationwide analysis. Obesity. 2017 doi: 10.1002/oby.21759. PubMed DOI

Antoniou SA, Anastasiadou A, Antoniou GA, Granderath F-A, Kafatos A. Preoperative nutritional counseling versus standard care prior to bariatric surgery: Effects on postoperative weight loss. Eur Surg Acta Chir Aust. 2017 doi: 10.1007/s10353-016-0459-4. DOI

Bennett S, Gostimir M, Shorr R, Mallick R, Mamazza J, Neville A. The role of routine preoperative upper endoscopy in bariatric surgery: a systematic review and meta-analysis. Surg Obes Relat Dis. 2016 doi: 10.1016/j.soard.2016.04.012. PubMed DOI

Parikh M, Liu J, Vieira D, et al. Preoperative endoscopy prior to bariatric surgery: a systematic review and meta-analysis of the literature. Obes Surg. 2016 doi: 10.1007/s11695-016-2232-y. PubMed DOI

Dawes AJ, Maggard-Gibbons M, Maher AR, et al. Mental health conditions among patients seeking and undergoing bariatric surgery a meta-analysis. JAMA. 2016 doi: 10.1001/jama.2015.18118. PubMed DOI

De Luca M, Angrisani L, Himpens J, et al. Indications for surgery for obesity and weight-related diseases: position statements from the international federation for the surgery of obesity and metabolic disorders (IFSO) Obes Surg. 2016 doi: 10.1007/s11695-016-2271-4. PubMed DOI PMC

Mokhlesi B, Hovda MD, Vekhter B, Arora VM, Chung F, Meltzer DO. Sleep-disordered breathing and postoperative outcomes after bariatric surgery: analysis of the nationwide inpatient sample. Obes Surg. 2013 doi: 10.1007/s11695-013-0991-2. PubMed DOI PMC

Elrashidy AA, Elsherif M, Elhag W, Abdel-Rahman RS, Abdelaziem S. Does obstructive sleep apnea (OSA) increase the risk of post-operative respiratory complications after bariatric surgery? Open J Anesthesiol. 2018;08(10):255–266. doi: 10.4236/ojanes.2018.810026. DOI

Xará D, Mendonça J, Pereira H, Santos A, Abelha FJ. Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome. Braz J Anesthesiol. 2015 doi: 10.1016/j.bjane.2014.02.008. PubMed DOI

Toshniwal G, McKelvey GM, Wang H. STOP-Bang and prediction of difficult airway in obese patients. J Clin Anesth. 2014 doi: 10.1016/j.jclinane.2014.01.010. PubMed DOI

Hallowell PT, Stellato TA, Petrozzi MC, et al. Eliminating respiratory intensive care unit stay after gastric bypass surgery. Surgery. 2007 doi: 10.1016/j.surg.2007.08.002. PubMed DOI

Weingarten TN, Flores AS, McKenzie JA, et al. Obstructive sleep apnoea and perioperative complications in bariatric patients. Br J Anaesth. 2011 doi: 10.1093/bja/aeq290. PubMed DOI

Jensen C, Tejirian T, Lewis C, Yadegar J, Dutson E, Mehran A. Postoperative CPAP and BiPAP use can be safely omitted after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008 doi: 10.1016/j.soard.2008.05.003. PubMed DOI

Proczko MA, Stepaniak PS, de Quelerij M, et al. STOP-Bang and the effect on patient outcome and length of hospital stay when patients are not using continuous positive airway pressure. J Anesth. 2014 doi: 10.1007/s00540-014-1848-0. PubMed DOI PMC

Kurrek MM, Cobourn C, Wojtasik Z, Kiss A, Dain SL. Morbidity in patients with or at high risk for obstructive sleep apnea after ambulatory laparoscopic gastric banding. Obes Surg. 2011 doi: 10.1007/s11695-011-0381-6. PubMed DOI

Nepomnayshy D, Hesham W, Erickson B, MacDonald J, Iorio R, Brams D. Sleep apnea: is routine preoperative screening necessary? Obes Surg. 2013 doi: 10.1007/s11695-012-0806-x. PubMed DOI

Shearer E, Magee CJ, Lacasia C, Raw D, Kerrigan D. Obstructive sleep apnea can be safely managed in a level 2 critical care setting after laparoscopic bariatric surgery. Surg Obes Relat Dis. 2013 doi: 10.1016/j.soard.2012.09.006. PubMed DOI

El Shobary H, Backman S, Christou N, Schricker T. Use of critical care resources after laparoscopic gastric bypass: effect on respiratory complications. Surg Obes Relat Dis. 2008 doi: 10.1016/j.soard.2008.02.003. PubMed DOI

Lyons MM, Keenan BT, Li J, et al. Symptomless multi-variable apnea prediction index assesses obstructive sleep apnea risk and adverse outcomes in elective surgery. Sleep. 2017 doi: 10.1093/sleep/zsw081. PubMed DOI PMC

Grover BT, Priem DM, Mathiason MA, Kallies KJ, Thompson GP, Kothari SN. Intensive care unit stay not required for patients with obstructive sleep apnea after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2010 doi: 10.1016/j.soard.2009.12.006. PubMed DOI

Ahmad S, Nagle A, McCarthy RJ, Fitzgerald PC, Sullivan JT, Prystowsky J. Postoperative hypoxemia in morbidly obese patients with and without obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesth Analg. 2008 doi: 10.1213/ane.0b013e318174df8b. PubMed DOI

Meng L. Postoperative nausea and vomiting with application of postoperative continuous positive airway pressure after laparoscopic gastric bypass. Obes Surg. 2010 doi: 10.1007/s11695-008-9741-2. PubMed DOI

Meurgey JH, Brown R, Woroszyl-Chrusciel A, Steier J. Peri-operative treatment of sleep-disordered breathing and outcomes in bariatric patients. J Thorac Dis. 2018 doi: 10.21037/jtd.2017.10.11. PubMed DOI PMC

Imberti D, Baldini E, Pierfranceschi MG, et al. Prophylaxis of venous thromboembolism with low molecular weight heparin in bariatric surgery: a prospective, randomised pilot study evaluating two doses of parnaparin (BAFLUX study) Obes Surg. 2014 doi: 10.1007/s11695-013-1105-x. PubMed DOI PMC

Steele KE, Canner J, Prokopowicz G, et al. The EFFORT trial: Preoperative enoxaparin versus postoperative fondaparinux for thromboprophylaxis in bariatric surgical patients: a randomized double-blind pilot trial. Surg Obes Relat Dis. 2015 doi: 10.1016/j.soard.2014.10.003. PubMed DOI

Kaw R, Pasupuleti V, Wayne Overby D, et al. Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis. Surg Obes Relat Dis. 2014 doi: 10.1016/j.soard.2014.04.008. PubMed DOI

Małczak P, Pisarska M, Piotr M, Wysocki M, Budzyński A, Pędziwiatr M. Enhanced recovery after bariatric surgery: systematic review and meta-analysis. Obes Surg. 2017 doi: 10.1007/s11695-016-2438-z. PubMed DOI PMC

Singh PM, Panwar R, Borle A, et al. Efficiency and safety effects of applying ERAS protocols to bariatric surgery: a systematic review with meta-analysis and trial sequential analysis of evidence. Obes Surg. 2017 doi: 10.1007/s11695-016-2442-3. PubMed DOI

Ng JJ, Leong WQ, Tan CS, et al. A multimodal analgesic protocol reduces opioid-related adverse events and improves patient outcomes in laparoscopic sleeve gastrectomy. Obes Surg. 2017 doi: 10.1007/s11695-017-2790-7. PubMed DOI

Bamgbade OA, Oluwole O, Khaw RR. Perioperative analgesia for fast-track laparoscopic bariatric surgery. Obes Surg. 2017 doi: 10.1007/s11695-017-2562-4. PubMed DOI

Ziemann-Gimmel P, Hensel P, Koppman J, Marema R. Multimodal analgesia reduces narcotic requirements and antiemetic rescue medication in laparoscopic Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2013 doi: 10.1016/j.soard.2013.02.003. PubMed DOI

El Sherif FA, Othman AH, Abd El-Rahman AM, Taha O. Effect of adding intrathecal morphine to a multimodal analgesic regimen for postoperative pain management after laparoscopic bariatric surgery: a prospective, double-blind, randomized controlled trial. Br J Pain. 2016 doi: 10.1177/2049463716668904. PubMed DOI PMC

Na HS, Oh AY, Ryu JH, et al. Intraoperative nefopam reduces acute postoperative pain after laparoscopic gastrectomy: a prospective randomized study. J Gastrointest Surg. 2018 doi: 10.1007/s11605-018-3681-5. PubMed DOI

Feld JM, Laurito CE, Beckerman M, Vincent J, Hoffman WE. Non-opioid analgesia improves pain relief and decreases sedation after gastric bypass surgery. Can J Anesth. 2003 doi: 10.1007/BF03021029. PubMed DOI

Song K, Melroy MJ, Whipple OC. Optimizing multimodal analgesia with intravenous acetaminophen and opioids in postoperative bariatric patients. Pharmacotherapy. 2014 doi: 10.1002/phar.1517. PubMed DOI

El Sayed M, Abdelsamad A, Amer A. Shorter postanesthesia care unit stay with dexmedetomidine infusion during laparoscopic bariatric surgery: a randomized controlled trial. Res Opin Anesth Intensive Care. 2017 doi: 10.4103/roaic.roaic_103_16. DOI

De Oliveira GS, Duncan K, Fitzgerald P, Nader A, Gould RW, McCarthy RJ. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014 doi: 10.1007/s11695-013-1077-x. PubMed DOI

Horsley R, Vogels E, McField D, et al. Multimodal postoperative pain control is effective and reduces narcotic use after laparoscopic Roux-en-Y gastric bypass (LRYGB) Surg Obes Relat Dis. 2016 doi: 10.1016/j.soard.2016.08.145. PubMed DOI

Gill RS, Majumdar SR, Rueda-Clausen CF, et al. Comparative effectiveness and safety of gastric bypass, sleeve gastrectomy and adjustable gastric banding in a population-based bariatric program: prospective cohort study. Can J Surg. 2016;59(4):233–241. doi: 10.1503/cjs.013315. PubMed DOI PMC

Angrisani L, Cutolo PP, Formisano G, Nosso G, Vitolo G. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 2013;9(3):405–413. doi: 10.1016/j.soard.2012.11.011. PubMed DOI

Campos GM. Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding. Arch Surg. 2011;146(2):149. doi: 10.1001/archsurg.2010.316. PubMed DOI

Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the longitudinal assessment of bariatric surgery (LABS) study. JAMA Surg. 2018;153(5):427. doi: 10.1001/jamasurg.2017.5025. PubMed DOI PMC

Dogan K, Gadiot RPM, Aarts EO, et al. Effectiveness and safety of sleeve gastrectomy, gastric bypass, and adjustable gastric banding in morbidly obese patients: a multicenter, retrospective, matched cohort study. Obes Surg. 2015;25(7):1110–1118. doi: 10.1007/s11695-014-1503-8. PubMed DOI

Flint R. A comparison of laparoscopic adjustable gastric band and laparoscopic sleeve gastrectomy: a single surgeon’s experience. N Z Med J. 2015;128:56. PubMed

Lee SK, Heo Y, Park J-M, et al. Roux-en-Y gastric bypass vs sleeve gastrectomy vs gastric banding: the first multicenter retrospective comparative cohort study in obese Korean patients. Yonsei Med J. 2016;57(4):956. doi: 10.3349/ymj.2016.57.4.956. PubMed DOI PMC

Nguyen NT, Slone JA, Nguyen X-MT, Hartman JS, Hoyt DB. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity. Trans Am Surg Assoc. 2009;127:262–272. doi: 10.1097/SLA.0b013e3181b92480. PubMed DOI

Nguyen NT, Kim E, Vu S, Phelan M. Ten-year outcomes of a prospective randomized trial of laparoscopic gastric bypass versus laparoscopic gastric banding. Ann Surg. 2018;268(1):106–113. doi: 10.1097/SLA.0000000000002348. PubMed DOI PMC

Novikov AA, Afaneh C, Saumoy M, et al. Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic band for weight loss: how do they compare? J Gastrointest Surg. 2018;22(2):267–273. doi: 10.1007/s11605-017-3615-7. PubMed DOI

Sabbagh C, Verhaeghe P, Dhahri A, et al. Two-year results on morbidity, weight loss and quality of life of sleeve gastrectomy as first procedure, sleeve gastrectomy after failure of gastric banding and gastric banding. Obes Surg. 2010;20(6):679–684. doi: 10.1007/s11695-009-0007-4. PubMed DOI

Schouten R, Wiryasaputra DC, van Dielen FMH, van Gemert WG, Greve JWM. Long-term results of bariatric restrictive procedures: a prospective study. Obes Surg. 2010;20(12):1617–1626. doi: 10.1007/s11695-010-0211-2. PubMed DOI PMC

Schouten R, Wiryasaputra DCMS, van Dielen FMH, van Gemert WG, Greve JWM. Influence of reoperations on long-term quality of life after restrictive procedures: a prospective study. Obes Surg. 2011;21(7):871–879. doi: 10.1007/s11695-010-0350-5. PubMed DOI PMC

Kang JH, Le QA. Effectiveness of bariatric surgical procedures: a systematic review and network meta-analysis of randomized controlled trials. Medicine. 2017 doi: 10.1097/MD.0000000000008632. PubMed DOI PMC

Kodama S, Fujihara K, Horikawa C, et al. Network meta-analysis of the relative efficacy of bariatric surgeries for diabetes remission. Obes Rev. 2018 doi: 10.1111/obr.12751. PubMed DOI

Grubnik VV, Ospanov OB, Namaeva KA, Medvedev OV, Kresyun MS. Randomized controlled trial comparing laparoscopic greater curvature plication versus laparoscopic sleeve gastrectomy. Surg Endosc. 2016 doi: 10.1007/s00464-015-4373-9. PubMed DOI

Bužga M, Švagera Z, Tomášková H, Hauptman K, Holéczy P. Metabolic effects of sleeve gastrectomy and laparoscopic greater curvature plication: an 18-month prospective, observational, open label study. Obes Surg. 2017 doi: 10.1007/s11695-017-2779-2. PubMed DOI

Shikora SA, Mahoney CB. Clinical benefit of gastric staple line reinforcement (SLR) in gastrointestinal surgery: a meta-analysis. Obes Surg. 2015 doi: 10.1007/s11695-015-1703-x. PubMed DOI PMC

Wang Z, Dai X, Xie H, Feng J, Li Z, Lu Q. The efficacy of staple line reinforcement during laparoscopic sleeve gastrectomy: a meta-analysis of randomized controlled trials. Int J Surg. 2016 doi: 10.1016/j.ijsu.2015.12.007. PubMed DOI

Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016 doi: 10.1016/j.soard.2016.01.022. PubMed DOI

Wang Y, Yi XY, Gong L, Li Q, Zhang J, Wang Z. The effectiveness and safety of laparoscopic sleeve gastrectomy with different sizes of bougie calibration: a systematic review and meta-analysis. Int J Surg. 2018 doi: 10.1016/j.ijsu.2017.12.005. PubMed DOI

McGlone ER, Gupta AK, Reddy M, Khan OA. Antral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: systematic review and meta-analysis. Surg Obes Relat Dis. 2018 doi: 10.1016/j.soard.2018.02.021. PubMed DOI

Gagner M, Deitel M, Erickson AL, Crosby RD. Survey on laparoscopic sleeve gastrectomy (LSG) at the fourth international consensus summit on sleeve gastrectomy. Obes Surg. 2013 doi: 10.1007/s11695-013-1040-x. PubMed DOI

Li J, Lai D, Wu D. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy to treat morbid obesity-related comorbidities: a systematic review and meta-analysis. Obes Surg. 2016;26(2):429–442. doi: 10.1007/s11695-015-1996-9. PubMed DOI

Osland E, Yunus RM, Khan S, Alodat T, Memon B, Memon MA. Postoperative early major and minor complications in laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a meta-analysis and systematic review. Obes Surg. 2016;26(10):2273–2284. doi: 10.1007/s11695-016-2101-8. PubMed DOI

Osland E, Yunus RM, Khan S, Memon B, Memon MA. Late postoperative complications in laparoscopic sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-y gastric bypass (LRYGB) Surg Laparosc Endosc Percutan Tech. 2016;26(3):193–201. doi: 10.1097/SLE.0000000000000279. PubMed DOI

Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity. JAMA. 2018;319(3):255. doi: 10.1001/jama.2017.20897. PubMed DOI PMC

Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity. JAMA. 2018;319(3):241. doi: 10.1001/jama.2017.20313. PubMed DOI PMC

Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017 doi: 10.1007/s11695-017-2666-x. PubMed DOI PMC

Polega JR, Barreto TW, Kemmeter KD, Koehler TJ, Davis AT, Kemmeter PR. A matched cohort study of laparoscopic biliopancreatic diversion with duodenal switch and sleeve gastrectomy performed by one surgeon. Surg Obes Relat Dis. 2017 doi: 10.1016/j.soard.2016.10.023. PubMed DOI

Sucandy I, Titano J, Bonanni F, Antanavicius G. Comparison of vertical sleeve gastrectomy versus biliopancreatic diversion. N Am J Med Sci. 2014 doi: 10.4103/1947-2714.125865. PubMed DOI PMC

Hedberg J, Sundbom M. Superior weight loss and lower HbA1c 3 years after duodenal switch compared with Roux-en-Y gastric bypass: a randomized controlled trial. Surg Obes Relat Dis. 2012 doi: 10.1016/j.soard.2012.01.014. PubMed DOI

Laurenius A, Taha O, Maleckas A, Lönroth H, Olbers T. Laparoscopic biliopancreatic diversion/duodenal switch or laparoscopic Roux-en-Y gastric bypass for super-obesity—weight loss versus side effects. Surg Obes Relat Dis. 2010;6(4):408–414. doi: 10.1016/j.soard.2010.03.293. PubMed DOI

Søvik TT, Taha O, Aasheim ET, et al. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010 doi: 10.1002/bjs.6802. PubMed DOI

Sudan R, Jain-Spangler K. Tailoring bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. J Laparoendosc Adv Surg Tech. 2018 doi: 10.1089/lap.2018.0397. PubMed DOI

Mahawar KK, Himpens J, Shikora SA, et al. The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified delphi approach. Obes Surg. 2018;28(2):303–312. doi: 10.1007/s11695-017-3070-2. PubMed DOI

Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Te HM. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005 doi: 10.1097/01.sla.0000167762.46568.98. PubMed DOI PMC

Ruiz-Tovar J, Carbajo MA, Jimenez JM, et al. Long-term follow-up after sleeve gastrectomy versus Roux-en-Y gastric bypass versus one-anastomosis gastric bypass: a prospective randomized comparative study of weight loss and remission of comorbidities. Surg Endosc. 2019 doi: 10.1007/s00464-018-6307-9. PubMed DOI

Quan Y, Huang A, Ye M, et al. Efficacy of laparoscopic mini gastric bypass for obesity and type 2 diabetes mellitus: a systematic review and meta-analysis. Gastroenterol Res Pract. 2015 doi: 10.1155/2015/152852. PubMed DOI PMC

Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Sioka E, Zacharoulis D. One-anastomosis gastric bypass versus sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis. Obes Surg. 2017 doi: 10.1007/s11695-017-2807-2. PubMed DOI

Wang FG, Yu ZP, Yan WM, Yan M, Song MM. Comparison of safety and effectiveness between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy: a meta-analysis and systematic review. Medicine. 2017 doi: 10.1097/MD.0000000000008924. PubMed DOI PMC

Seetharamaiah S, Tantia O, Goyal G, et al. LSG vs OAGB—1 Year Follow-up Data—a Randomized Control Trial. Obes Surg. 2017 doi: 10.1007/s11695-016-2403-x. PubMed DOI

Darabi S, Talebpour M, Zeinoddini A, Heidari R. Laparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial. Surg Obes Relat Dis. 2013 doi: 10.1016/j.soard.2013.07.012. PubMed DOI

Cottam A, Cottam D, Medlin W, et al. A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up. Surg Endosc. 2016 doi: 10.1007/s00464-015-4707-7. PubMed DOI

Surve A, Zaveri H, Cottam D, Belnap LG, Cottam A, Cottam S. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017 doi: 10.1016/j.soard.2016.11.020. PubMed DOI

Lee WJ, Almulaifi AM, Tsou JJ, Ser KH, Lee YC, Chen SC. Duodenal-jejunal bypass with sleeve gastrectomy versus the sleeve gastrectomy procedure alone: the role of duodenal exclusion. Surg Obes Relat Dis. 2015 doi: 10.1016/j.soard.2014.12.017. PubMed DOI

Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide survey 2016: Primary, endoluminal, and revisional procedures. Obes Surg. 2018 doi: 10.1007/s11695-018-3450-2. PubMed DOI

Brethauer SA, Kothari S, Sudan R, et al. Systematic review on reoperative bariatric surgery American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 2014 doi: 10.1016/j.soard.2014.02.014. PubMed DOI

Bonouvrie DS, Uittenbogaart M, Luijten AAPM, van Dielen FMH, Leclercq WKG. Lack of standard definitions of primary and secondary (non)responders after primary gastric bypass and gastric sleeve: a systematic review. Obes Surg. 2019 doi: 10.1007/s11695-018-3610-4. PubMed DOI

Yumuk V, Tsigos C, Fried M, et al. European guidelines for obesity management in adults. Obes Facts. 2015 doi: 10.1159/000442721. PubMed DOI PMC

Inabnet WB, Belle SH, Bessler M, et al. Comparison of 30-day outcomes after non-LapBand primary and revisional bariatric surgical procedures from the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2010 doi: 10.1016/j.soard.2009.10.007. PubMed DOI PMC

Rudolph A, Hilbert A. Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2013 doi: 10.1111/obr.12013. PubMed DOI

Magouliotis DE, Tasiopoulou VS, Svokos AA, et al. Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: an updated systematic review and meta-analysis. Obes Surg. 2017 doi: 10.1007/s11695-017-2924-y. PubMed DOI

Li Z, Zhou X, Fu W. Vitamin D supplementation for the prevention of vitamin D deficiency after bariatric surgery: a systematic review and meta-analysis. Eur J Clin Nutr. 2018 doi: 10.1038/s41430-017-0059-9. PubMed DOI

Ying WCV, Song SH, Khan K, et al. Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies. Surg Endosc. 2015 doi: 10.1007/s00464-014-3794-1. PubMed DOI

Stewart F, Avenell A. Behavioural interventions for severe obesity before and/or after bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2016 doi: 10.1007/s11695-015-1873-6. PubMed DOI

Basbug A, Ellibeş Kaya A, Dogan S, Pehlivan M, Goynumer G. Does pregnancy interval after laparoscopic sleeve gastrectomy affect maternal and perinatal outcomes? J Matern Fetal Neonatal Med. 2018;32(22):3764–3770. doi: 10.1080/14767058.2018.1471678. PubMed DOI

Crusell M, Nilas L, Svare J, Lauenborg J. A Time interval of more than 18 months between a pregnancy and a Roux-en-Y gastric bypass increases the risk of iron deficiency and anaemia in pregnancy. Obes Surg. 2016 doi: 10.1007/s11695-016-2130-3. PubMed DOI

Rasteiro C, Araújo C, Cunha S, et al. Influence of time interval from bariatric surgery to conception on pregnancy and perinatal outcomes. Obes Surg. 2018 doi: 10.1007/s11695-018-3395-5. PubMed DOI

Rottenstreich A, Levin G, Kleinstern G, Rottenstreich M, Elchalal U, Elazary R. The effect of surgery-to-conception interval on pregnancy outcomes after sleeve gastrectomy. Surg Obes Relat Dis. 2018 doi: 10.1016/j.soard.2018.09.485. PubMed DOI

Stentebjerg LL, Andersen LLT, Renault K, Støving RK, Jensen DM. Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass. J Matern Neonatal Med. 2017 doi: 10.1080/14767058.2016.1208746. PubMed DOI

Yau PO, Parikh M, Saunders JK, Chui P, Zablocki T, Welcome AU. Pregnancy after bariatric surgery: the effect of time-to-conception on pregnancy outcomes. Surg Obes Relat Dis. 2017 doi: 10.1016/j.soard.2017.07.015. PubMed DOI

Jirapinyo P, Haas AV, Thompson CC. Effect of the Duodenal-jejunal bypass liner on glycemic control in patients with type 2 diabetes with obesity: a meta-analysis with secondary analysis on weight loss and hormonal changes. Diabetes Care. 2018 doi: 10.2337/dc17-1985/-/DC1. PubMed DOI

Thompson CC, Dayyeh BKA, Kushnir V, et al. Aspiration therapy for the treatment of obesity: 2–4 year results of the PATHWAY multicenter randomized controlled trial. Surg Obes Relat Dis. 2018;14(11):S4–S5. doi: 10.1016/j.soard.2018.09.018. PubMed DOI

Busetto L, Torres AJ, Morales S, et al. Impact of Abiliti® sensor-based feedback on eating behavior, physical activity and weight-loss in obese patients. Obes Surg. 2015;28(6):1766–1774.

Horbach T, Thalheimer A, Seyfried F, Eschenbacher F, Schuhmann P, Meyer G. abiliti® closed-loop gastric electrical stimulation system for treatment of obesity: clinical results with a 27-month follow-up. Obes Surg. 2015 doi: 10.1007/s11695-015-1620-z. PubMed DOI PMC

Torres A, Meyer G, Conde SM, et al (2015) Closed-loop gastric electrical stimulation (CLGES) with behavioral feedback for treatment of obesity: prospective multicenter trial with 18 month follow-up. Obes Surg

Sarr MG, Billington CJ, Brancatisano R, et al. The EMPOWER study: randomized, prospective, double-blind, multicenter trial of vagal blockade to induce weight loss in morbid obesity. Obes Surg. 2012 doi: 10.1007/s11695-012-0751-8. PubMed DOI

Ikramuddin S, Blackstone RP, Brancatisano A, et al. Effect of reversible intermittent intra-abdominal vagal nerve blockade on morbid obesity: the ReCharge randomized clinical trial. JAMA. 2014 doi: 10.1001/jama.2014.10540. PubMed DOI

Shikora SA, Wolfe BM, Apovian CM, et al. Sustained blockade weight loss with vagal nerve but not with sham: 18-month results of the ReCharge trial. J Obes. 2015 doi: 10.1155/2015/365604. PubMed DOI PMC

Apovian CM, Shah SN, Wolfe BM, et al. Two-year outcomes of vagal nerve blocking (vBloc) for the treatment of obesity in the ReCharge trial. Obes Surg. 2017 doi: 10.1007/s11695-016-2325-7. PubMed DOI PMC

van Baar ACG, Nieuwdorp M, Holleman F, et al. Duodenal mucosal resurfacing elicits improvement in glycemic and hepatic parameters in type 2 diabetes—one-year multicenter study results. Diabetes. 2018;67(Supplement 1):1137. doi: 10.2337/db18-1137-P. DOI

Miller K, Turró R, Greve JW, Bakker CM, Buchwald JN, Espinós JC. MILEPOST multicenter randomized controlled trial: 12-month weight loss and satiety outcomes after poseSMvs, medical therapy. Obes Surg. 2017 doi: 10.1007/s11695-016-2295-9. PubMed DOI

Sullivan S, Swain JM, Woodman G, et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: the ESSENTIAL trial. Obesity. 2017 doi: 10.1002/oby.21702. PubMed DOI

López-Nava G, Bautista-Castaño I, Jimenez A, De Grado T, Fernandez-Corbelle JP. The primary obesity surgery endolumenal (POSE) procedure: one-year patient weight loss and safety outcomes. Surg Obes Relat Dis. 2015 doi: 10.1016/j.soard.2014.09.026. PubMed DOI

Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017 doi: 10.1016/j.cgh.2016.12.012. PubMed DOI

Ahishali E. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Turkish J Gastroenterol. 2018 doi: 10.5152/tjg.2018.180501. PubMed DOI PMC

Lopez-Nava G, Galvão M, Bautista-Castaño I, Fernandez-Corbelle J, Trell M, Lopez N. Endoscopic sleeve gastroplasty for obesity treatment: two years of experience. Arq Bras Circ Dig. 2017;30(1):18–20. doi: 10.1590/0102-6720201700010006. PubMed DOI PMC

Lopez-Nava G, Galvao M, Bautista-Castaño I, Fernandez-Corbelle J, Trell M. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success. Endosc Int Open. 2016 doi: 10.1055/s-0041-110771. PubMed DOI PMC

Alqahtani A, Al-Darwish A, Mahmoud AE, Alqahtani YA, Elahmedi M. Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc. 2019 doi: 10.1016/j.gie.2018.12.012. PubMed DOI

EAES rapid guideline: systematic review, network meta-analysis, CINeMA and GRADE assessment, and European consensus on bariatric surgery-extension 2022

Endoscopic Treatment of Obesity and Nutritional Aspects of Bariatric Endoscopy