Hamdan Medical Journal (previously the Journal of Medical Sciences)

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Metabolic Surgery. A New Surgical Discipline?

Nicola Scopinaro
Published in : Journal of Medical Sciences ; Vol 3, No 1 (2010)
DOI : 10.2174/1996327001003010028

Abstract


Metabolic surgery can be considered as part of functional surgery, where the function to be corrected is a metabolic one. The first known example of metabolic surgery is probably the partial ileal bypass for the treatment of hypercholesterolemia. Modern metabolic surgery was preceded and inspired by bariatric surgery, basing on the strong metabolic effect of some obesity surgery operations, especially gastric bypass and biliopancreatic diversion (BPD), mainly active on type 2 diabetes mellitus. A true metabolic operation, primarily aimed at obtaining a favourable metabolic change, should on one side not provoke undue weight loss, on the other side act through specific mechanisms independent of weight changes. BPD, in clinical use since the late 70s, has proven to meet these requirements and is successfully used today in clinical trials for the treatment of the metabolic syndrome. New developed metabolic operations are represented by duodenal-jejunal bypass, endointestinal sleeve, and ileal interposition. All the efforts should be aimed at conceiving an operation equally effective as BPD, yet less invasive.

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