Actualización bibliográfica de la cirugía bariátrica, indicaciones y complicaciones

Abstract

Bariatric surgery procedures have significantly increased worldwide and have evolved from open surgery to laparoscopic surgery. Although complication and mortality rates have decreased, 40% of patients still face postoperative complications. This descriptive study aimed to describe the indications, techniques, and complications of bariatric surgery in the treatment of obesity. An exhaustive search was conducted in Pubmed and ScienceDirect using the PICO strategy. Then, 199 articles published between 2018 and 2022 were included, of which 44 met inclusion and exclusion criteria. Results showed that bariatric surgery is effective in the treatment of morbid obesity and its comorbidities. Bariatric procedures are classified according to their mechanism of action as restrictive, malabsorptive, or mixed. The main indication for its adoption was having a BMI of ≥ 40 kg/m2 or BMI > 35 kg/m2 following comorbidities. In addition, it is important to consider the complications after this type of operation, which can be classified as early, like bleeding (23%), anastomotic leak (18%), and anastomotic stenosis (11%), and late, like hernias (21%), stenosis, and marginal ulceration (12%). Studies indicate that bariatric surgery causes significant weight loss in the medium term (%EWL: ≥ 70% and %TWL: ≥ 30%) and long term (%EWL: ≥ 50% and %TWL: ≥ 30%); in addition, it improves obesity-related comorbidities. However, it is also necessary to apply an individualized and multidisciplinary approach to each patient.