Surgery for Obesity Flashcards
For whom does the NIH recommend bariatric surgery?
People with BMI >40 or BMI >35 with significant co-morbidities.
2 categories of bariatric surgery?
Restrictive (stapling, lap-band, etc.)
Malabsorptive (duodenal switch, bypass, etc.)
How does Roux-en-Y gastric bypass work: What’s connected to what?
Small gastric pouch made, connected down to jejunum.
Pancreatic stuff flows into jejunum as well.
What’s the duodenal switch operation?
Gastric sleeve resection, then
Duodenum kept, but brought down to distal jejunum (most of jejunum is bypassed).
Where did the gastric sleeve resection come from?
Came from the duodenal switch operation being done in 2 parts- but people realized that the gastric sleeve itself worked pretty well.
What hormonal reason likely makes the gastric sleeve resection extra effective?
Ghrelin (pro-hunger hormone) is produced in the fundus of the stomach - if that’s removed, there’s less drive to eat.
How long, roughly, does it take glucose levels to normalize after gastric bypass?
Days to weeks - not long at all.
it cures and prevents type 2 diabetes
Do people with bariatric surgery tend to live longer?
Yes, about 7 years longer.
Effect of bariatric surgery on cancer rates?
Reduces cancer risk in women, but not in men.
Is bariatric surgery safer than a cholecystectomy?
Is it cost effective?
Yep.
Yes, at less than $50,000/QALY.
