UpToDate خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده:
4
September 2025
| Procedure | Brief description | Expected %TWL | Indications | Contraindications |
| Sleeve Gastrectomy | ~75% of the stomach removed, creating a tubular stomach | 25 to 30% | BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities; high-risk patients awaiting organ transplant | Severe GERD*, Barrett's esophagus*, high-risk leak potential, prior gastric surgery |
| Roux-en-Y Gastric Bypass | Stomach reduced to a small pouch; bypasses proximal small bowel | 30 to 35% | BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities; T2DM, GERD, severe obesity | Short bowel syndrome, Crohn's disease*, severe malnutrition, previous major gastric surgery |
| One-Anastomosis Gastric Bypass | Gastric pouch with a single anastomosis to the small intestine (loop) | 25 to 35% | BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities; T2DM | Severe GERD, bile reflux, liver disease, Crohn's disease |
| Biliopancreatic Diversion with Duodenal Switch | Sleeve gastrectomy + duodenum bypassed to distal ileum in a Roux-en-Y configuration | ≥40% | BMI ≥50 kg/m2 or ≥40 kg/m2 with severe comorbidities; revision for failure to lose weight or weight recidivism | Severe malnutrition, Crohn's disease*, short bowel syndrome, nonadherence risk |
| Single Anastomosis Duodenoileal Bypass with Sleeve | Sleeve gastrectomy + single duodenum to ileal (loop) bypass | 35 to 40% | BMI ≥50 kg/m2 or ≥40 kg/m2 with severe comorbidities; T2DM, severe obesity; revision for failure to lose weight or weight recidivism | Severe malnutrition, Crohn's disease*, short bowel syndrome, poor dietary adherence |
| Intragastric Balloon | Balloon placed into the stomach to reduce stomach volume and increase satiety | 6 to 15% | BMI ≥30 kg/m2, or 27 to 29.9 kg/m2 with comorbidities; adjunct to lifestyle changes; prior to other bariatric procedures | Prior gastric/bariatric surgery, large hiatal hernia, gastroparesis, pregnancy |
| Adjustable Gastric Band | Inflatable silicone band around stomach to limit intake | 10 to 15% | BMI ≥35 kg/m2 or ≥30 kg/m2 with comorbidities; lower risk candidates | Severe GERD, prior upper GI surgery, poor compliance, eating disorders |
| Endoscopic Gastric Remodelling | Various endoscopic suturing devices reduce stomach volume (eg, ESG, POSE) | 10 to 20% | BMI ≥30 kg/m2, or 27 to 29.9 kg/m2 with comorbidities; adjunct to lifestyle changes; not for prior bariatric surgery | Prior gastric/bariatric surgery, large hiatal hernia, gastroparesis, poor adherence |
| Transpyloric Shuttle | An endoscopically placed gastric device that blocks the pylorus and prevents food from moving into the duodenum | 10 to 15% | BMI ≥30 kg/m2, or 27 to 29.9 kg/m2 with comorbidities; adjunct to lifestyle changes | Prior gastric/bariatric surgery, large hiatal hernia, gastroparesis, pregnancy |
| Transoral Outlet Reduction | Endoscopic revision of gastrojejunal anastomosis after Roux-en-Y gastric bypass | 5 to 10% | Weight regain post-Roux-en-Y; BMI >30 kg/m2 | Non-Roux-en-Y patients, large anastomosis (>4 cm), poor adherence |
%TWL: percent total weight loss; BMI: body mass index; ESG: endoscopic sleeve gastrectomy; GERD: gastroesophageal reflux disease; GI: gastrointestinal; POSE: primary obesity surgery endoluminal; T2DM: type 2 diabetes mellitus.
* Relative contraindication.
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