Journal of metabolic and bariatric surgery最新文献

{"title":"Effects of Bariatric Surgery in Patients With Class I Obesity (BMI 30-35 kg/m²): A Meta-Analysis of Retrospective Studies.","authors":"Muhammad Kamran Khan, Abdullah Musaad M AlHarbi, Moayad Abdulrahman S Alzamil, Ambreen Liaqat, Sultan Saud Bin Mohammed Bin Sifran, Areeba M Amin","doi":"10.17476/jmbs.2026.15.2.77","DOIUrl":"10.17476/jmbs.2026.15.2.77","url":null,"abstract":"<p><strong>Purpose: </strong>Over half the global population lives in countries where obesity complications cause higher morbidity than underweight status. Obesity, a global epidemic, carries substantial health, social, and economic consequences. Class I obesity (body mass index [BMI] 30-35 kg/m²) is increasingly prevalent and associated with metabolic comorbidities including type 2 diabetes mellitus (DM) and hypertension (HTN). While bariatric surgery is established for severe obesity, its efficacy in class I obesity remains debated. This meta-analysis evaluated weight loss and comorbidity remission following bariatric surgery in class I obesity.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Google Scholar, Cochrane Central, and ScienceDirect identified retrospective studies (2000-2024) reporting weight loss (%excess weight loss [EWL], %total weight loss, BMI) or comorbidity remission (DM, HTN) with ≥12-month follow-up in class I obesity patients undergoing bariatric surgery. Weight loss outcomes were restricted to sleeve gastrectomy (SG) for consistency. Pooled estimates and odds ratios (ORs) used random-effects models.</p><p><strong>Results: </strong>Nine retrospective studies (1,703 patients) met inclusion criteria. All had critical ROBINS-I bias risk. Following SG, pooled %EWL was 90.16% (95% CI, 71.21-109.11) at 12 months and 75.73% (95% CI, 74.66-76.80) at 24 months. Mean BMI fell to 24.70 kg/m² at 12 months and 25.66 kg/m² at 24 months. DM remission improved significantly (OR, 0.20; 95% CI, 0.07-0.57 at ≤2 years; OR, 0.15; 95% CI, 0.05-0.49 at >2 years). HTN remission was non-significant (OR, 0.80; 95% CI, 0.38-1.72 at ≤2 years; OR, 0.61; 95% CI, 0.22-1.64 at >2 years).</p><p><strong>Conclusion: </strong>SG achieves substantial sustained weight loss in class I obesity with significant diabetes remission. However, critical bias limits evidence certainty. High-quality prospective trials are urgently needed.</p><p><strong>Trial registration: </strong>PROSPERO Identifier: CRD420261296751.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"77-88"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal Wall Hernia After Metabolic and Bariatric Surgery: A Narrative Review.","authors":"Yoonhong Kim, Ki Hyun Kim, Seung Hun Lee, Yeajin Moon, Kyung Won Seo","doi":"10.17476/jmbs.2026.15.2.53","DOIUrl":"10.17476/jmbs.2026.15.2.53","url":null,"abstract":"<p><p>Abdominal wall hernias, including incisional and trocar site hernias (TSHs), represent a significant clinical challenge in the field of metabolic and bariatric surgery (MBS). Morbid obesity is a potent risk factor for fascial defects due to chronically elevated intra-abdominal pressure and impaired wound healing mechanisms. This narrative review explores the incidence, risk factors, and management strategies for hernias in the bariatric population. Evidence indicates that ventral hernias are prevalent in 8% to 20% of MBS candidates. Furthermore, TSH incidence is substantially higher in bariatric patients-reaching up to 34% to 40% in prospective studies-compared to general laparoscopic cohorts, where rates typically range from 0.1% to 1.5%. Management involves a strategic balance between concurrent and staged repair; while concurrent repair of small defects is safe, it is associated with a higher mesh infection rate (3.6%) compared to staged approaches (1.9%). However, the use of synthetic mesh remains essential to reduce recurrence rates from 25.7% to 1.1%. Prevention hinges on safe primary access techniques, such as Palmer's point or optical trocars, and meticulous fascial closure of larger ports, especially at specimen extraction sites where hernia rates can reach 22.4%. Meticulous management of modifiable comorbidities like diabetes and smoking is also vital to minimize 30-day wound morbidity. In conclusion, a high index of suspicion for TSH and a tailored approach to hernia repair are necessary to optimize long-term surgical outcomes in bariatric patients.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the AEON Powered Stapler System in Primary Sleeve Gastrectomy: Results of a Prospective Clinical Trial.","authors":"Antanas Mickevicius, Agne Sikarske, Mindaugas Kiudelis","doi":"10.17476/jmbs.2026.15.2.103","DOIUrl":"10.17476/jmbs.2026.15.2.103","url":null,"abstract":"<p><strong>Purpose: </strong>Staple-line complications such as bleeding and leaks remain clinically relevant in sleeve gastrectomy despite advances in surgical technique and device technology. This prospective trial was conducted to investigate the hypothesis that the AEON Powered Stapling System could improve consistency and stability of firing intraoperatively, which could lead to less tissue trauma, improved hemostasis, and fewer intra- and post-operative complications.</p><p><strong>Materials and methods: </strong>This was a prospective, single-center, single-arm study including 50 consecutive patients undergoing primary sleeve gastrectomy using the AEON Powered Stapling System. The primary endpoint was postoperative staple-line complications requiring intervention (bleeding or leak). Intraoperative hemostasis was assessed using a visual analogue scale (VAS). Postoperative outcomes and early quality-of-life (QOL) changes were evaluated.</p><p><strong>Results: </strong>Fifty patients (49 female; mean age 38.5±7.4 years; mean body mass index 35.8±3.7 kg/m²) underwent sleeve gastrectomy. Mean intraoperative VAS bleeding score was 1.04±0.19. No intraoperative bleeding requiring intervention occurred. There were no postoperative staple-line bleeds, leaks, reoperations, or device-related adverse events. Mean hemoglobin decrease was clinically insignificant, and no blood transfusions were required. Early postoperative pain scores were low and decreased progressively until discharge. In an exploratory analysis, improvement in five 36-Item Short Form Health Survey QOL domains was observed at 3 weeks.</p><p><strong>Conclusion: </strong>The AEON Powered Stapling System was safe and effective and demonstrated low intraoperative staple-line bleeding scores and a favorable short-term safety profile in primary sleeve gastrectomy. Because this was a single-arm study without a comparator group, larger comparative studies with longer follow-up are warranted.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06474637.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"103-112"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resectional Roux-en-Y Gastric Bypass Versus Standard Roux-en-Y Gastric Bypass: Impact of Concomitant Gastric Remnant Resection on Postoperative Complications and Weight Loss Outcomes in a High-Volume Center.","authors":"João Pedro Araújo Teixeira, Inês Faria Teixeira, Joana Lamego, Bárbara Peleteiro, Frederica Gonçalves, César Alvarez, Fernando Resende, André Costa Pinho, John Preto, Paula Freitas, Silvestre Carneiro, Hugo Santos Sousa, Eduardo Lima da Costa","doi":"10.17476/jmbs.2026.15.2.89","DOIUrl":"10.17476/jmbs.2026.15.2.89","url":null,"abstract":"<p><strong>Purpose: </strong>Concomitant gastric remnant resection (GRR) during Roux-en-Y gastric bypass (RYGB)-hereafter resectional RYGB (rRYGB)-may be required in selected cases, including premalignant conditions, persistent <i>Helicobacter pylori</i> infection, or revisional surgery, but is associated with increased morbidity. We evaluated the impact of rRYGB on surgical outcomes in a high-volume center.</p><p><strong>Materials and methods: </strong>A retrospective analysis included patients undergoing primary and revisional RYGB, divided by whether a concomitant GRR was performed (rRYGB) or not (standard RYGB). Intra- and postoperative complications, reintervention, mortality and weight loss were assessed.</p><p><strong>Results: </strong>Of 2,103 patients, 89 (4.2%) underwent rRYGB. The overall complication rate was higher with rRYGB, without reaching significance (14.6% vs. 8.9%; P=0.067), but was significant in primary RYGB (16.9% vs. 8.7%; P=0.023). rRYGB was associated with higher rates of leak/fistula (2.2% vs. 0.2%; P=0.001), food intolerance (2.2% vs. 0.3%; P=0.003), intra-abdominal collections (2.2% vs. 0.2%; P<0.001), and reintervention (7.9% vs. 3.1%; P=0.013). After adjustment, rRYGB remained independently associated with complications (odds ratio [OR], 2.30, 95% confidence interval [CI], 1.16-4.54) and reintervention (OR, 3.23, 95% CI, 1.31-7.96) in primary RYGB. Ninety-day mortality was zero. Weight loss tended to be greater with rRYGB (2-year total weight loss [TWL], 38.9% vs. 36.0%; excess weight loss, 99.7% vs. 92.0%), reaching significance for TWL in some adjusted analyses.</p><p><strong>Conclusion: </strong>rRYGB is associated with increased postoperative morbidity, particularly fistula, food intolerance, and intra-abdominal collections. The trend toward greater weight loss was inconsistent across measures and time points and should be regarded as exploratory. Careful patient selection and individualized decision-making are essential.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"89-102"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Safety Evaluation of the Bendos Q Powered Stapling System in Laparoscopic Sleeve Gastrectomy.","authors":"Sofía Lorenzo Mañas, Rafael Restrepo Núñez, Kléber Falcón Bonilla, Amaia González Rivas, Javier Goncalves Morales, Alfredo Vivas López","doi":"10.17476/jmbs.2026.15.2.113","DOIUrl":"10.17476/jmbs.2026.15.2.113","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure worldwide, but staple-line complications remain among the most feared adverse events, with leaks reported in approximately 1-5% of cases. The Bendos Q powered stapling system is a new device designed to improve tissue compression and staple-line consistency.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed a prospectively maintained database at a single bariatric center (July-December 2025), including the first consecutive series of patients who underwent primary LSG with the Bendos Q system. Primary outcomes were staple-line bleeding, staple-line leak, and major complications according to the Clavien-Dindo classification.</p><p><strong>Results: </strong>Twenty-four consecutive patients (58.3% women) underwent LSG. Mean age was 39.8±10.2 years and mean body mass index was 37.6±4.9 kg/m². Gastric transection was performed exclusively with green cartridges. Mean operative time was 65±10 minutes, with 5.1±0.7 stapler firings. No intraoperative complications occurred, and hemoglobin remained stable (13.0±0.6 g/dL at discharge). No staple-line bleeding, leaks, major complications, or reoperations were observed. Mean hospital stay was 2 days (range, 1-3).</p><p><strong>Conclusion: </strong>In this preliminary series, the Bendos Q powered stapling system was associated with favorable short-term perioperative outcomes in LSG, with no staple-line complications or major postoperative events observed. Although these findings are promising, the small sample size, single-center design, and absence of a comparator group warrant caution; larger comparative studies with longer follow-up are needed to confirm the safety of this device.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"113-120"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and Late Complications After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: A Narrative Review.","authors":"Sa-Hong Kim, Seung Jong Oh","doi":"10.17476/jmbs.2026.15.2.59","DOIUrl":"10.17476/jmbs.2026.15.2.59","url":null,"abstract":"<p><p>This review aimed to provide an updated overview of early and late complications after metabolic and bariatric surgery (MBS), focusing on incidence, mechanisms, diagnosis, and management, particularly for sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), the 2 most commonly performed procedures in Korea. We performed a narrative review, integrating evidence from recent meta-analyses, systematic reviews, large registry studies, and key guidelines or position statements, supplemented by representative Korean data and procedure-specific details. Early complications, including bleeding (SG 0.6-2.5%, RYGB 1-1.5%), leakage (SG ~1%, RYGB ~0.6%), and venous thromboembolism (0.3-2.4%), notably porto-mesenteric vein thrombosis (0.3-1.0%), remain uncommon yet potentially life-threatening. Advances in surgical technique, computed tomography-based evaluation, and thromboprophylaxis have reduced the incidence of early complications. Late complications are more prevalent and chronic, including gastroesophageal reflux disease (23-28%), sleeve stenosis or twist (0.5-3.5%), gastrojejunal anastomotic stricture (~6%), marginal ulcer (6-16%), internal hernia (0.2-9%), gallstone formation (up to 50%); nutritional deficiencies, including iron deficiency anemia (16-24%), vitamin B12, folate, vitamin D, and calcium deficiencies; and dumping syndrome (up to 40%) and post-bariatric hypoglycemia (~34%). MBS is a safe and effective treatment for severe obesity and its associated comorbidities. However, a procedure-specific understanding of complication patterns, risk factors, and stepwise management strategies is essential to minimize morbidity and to achieve long-term success through multidisciplinary care.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"59-76"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in 24-Hour Ambulatory Blood Pressure After Bariatric and Metabolic Surgery in Patients With Morbid Obesity: A Retrospective Cohort Study.","authors":"Dong-Wook Kim, Sungsoo Cho","doi":"10.17476/jmbs.2026.15.2.121","DOIUrl":"10.17476/jmbs.2026.15.2.121","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate changes in office and ambulatory blood pressure following bariatric and metabolic surgery in patients with morbid obesity.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed consecutive patients with morbid obesity who underwent bariatric and metabolic surgery between January 2020 and August 2023 at a single tertiary referral center. Office blood pressure and 24-hour ambulatory blood pressure monitoring were performed before surgery and repeated at 6 and 12 months postoperatively. The primary outcome was the change in mean 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP).</p><p><strong>Results: </strong>A total of 25 patients were included. The mean body mass index decreased from 39.2±6.9 kg/m² preoperatively to 32.2±5.2 kg/m² at 6 months and 28.8±4.2 kg/m² at 12 months. Office SBP significantly decreased from 140.3±10.7 mmHg at baseline to 128.0±9.4 mmHg at 12 months (P<0.001), while office DBP decreased from 87.0±6.9 mmHg to 82.2±6.4 mmHg (P<0.001). Likewise, mean 24-hour SBP decreased from 132.7±10.7 to 126.5±8.8 mmHg at 12 months (P=0.030), and mean 24-hour DBP decreased from 85.0±6.7 to 79.5±6.5 mmHg (P=0.040).</p><p><strong>Conclusion: </strong>Bariatric and metabolic surgery was associated with significant reductions in both office and ambulatory blood pressure during the first postoperative year.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"121-126"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elective Repair of Atypical Internal Hernia Following Roux-En-Y Gastric Bypass in a Patient With Recurrent Obstructive Symptoms: A Case Report.","authors":"Sarah Mahmood, Toufic Safi, Joseph Xavier, Fayez Hanna, Christophe R Berney","doi":"10.17476/jmbs.2026.15.2.127","DOIUrl":"10.17476/jmbs.2026.15.2.127","url":null,"abstract":"<p><p>Internal hernias are a well-recognized but potentially life-threatening complication following Roux-en-Y gastric bypass (RYGB). Diagnosis is often delayed due to non-specific symptoms and limitations of imaging, and surgical repair is frequently required. We present the case of a 47-year-old male with a history of RYGB who developed an atypical type of recurrent internal hernia, ultimately managed with elective exploratory laparotomy, reduction of hernia, closure of mesenteric defect and mesh repair of a concurrent incisional hernia. This case highlights the diagnostic challenges, surgical considerations, and importance of elective intervention in patients with a history of previous internal hernia repair post-bariatric surgery and presenting with recurrent subacute obstruction.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 2","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up Strategies in Metabolic and Bariatric Surgery: Current strategies and Challenges.","authors":"Sung Gon Kim, Sang Eok Lee, Dae Sung Yoon, In Seok Choi, Ju Ik Moon, Nak Song Sung, Seong Uk Kwon, In Eui Bae, Seung Jae Roh, Min Kyu Kim, Ran Song, Hee Jin Yeon, Youngjin Kim","doi":"10.17476/jmbs.2026.15.1.37","DOIUrl":"10.17476/jmbs.2026.15.1.37","url":null,"abstract":"<p><p>Metabolic and bariatric surgery (MBS) is an effective treatment for severe obesity and its related comorbidities. However, the long-term success and safety of these procedures depend heavily on continuous postoperative follow-up. Postoperative follow-up during the first year is essential for detecting surgical complications, monitoring weight loss trajectories, and optimizing nutritional status. Long-term follow-up is equally important for preventing weight regain, micronutrient deficiencies and recurrence of metabolic diseases. Structured and lifelong follow-up is a fundamental component of successful MBS. Despite recommendations from international societies, adherence to structured follow-up remains inconsistent in real-world practice. This review summarizes current evidence on optimal follow-up strategies after MBS, focusing on nutritional monitoring, management of complications, metabolic surveillance, psychosocial support, and multidisciplinary care.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 1","pages":"37-43"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Metabolic and Bariatric Surgery: Durability of Weight Loss, Metabolic Remission, and the Changing Treatment Landscape.","authors":"Yoonhong Kim, Ki Hyun Kim, Seung Hun Lee, Yeajin Moon, Yeongdo Oh, Kyung Won Seo","doi":"10.17476/jmbs.2026.15.1.10","DOIUrl":"10.17476/jmbs.2026.15.1.10","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing disease that leads to significant metabolic, cardiovascular, and functional consequences. Metabolic and bariatric surgery (MBS) remains the most effective evidence-based treatment for achieving substantial and lasting weight loss. Additionally, the emergence of incretin-based pharmacotherapy has transformed the long-term treatment landscape. Long-term studies demonstrate that MBS results in sustained weight reduction, durable improvements in type 2 diabetes, hypertension, and dyslipidemia, as well as lower risks of cardiovascular morbidity and all-cause mortality when compared to conventional care. However, long-term outcomes and risk profiles vary among different surgical procedures. Roux-en-Y gastric bypass typically yields better long-term metabolic and weight outcomes than older restrictive procedures and, in certain cases, sleeve gastrectomy. While sleeve gastrectomy is effective, it raises concerns about reflux-related complications over time. More malabsorptive procedures, such as the duodenal switch, may achieve greater weight loss in patients with severe obesity but come with a higher nutritional burden and late adverse events. Overall, current evidence supports MBS as a treatment that modifies the disease rather than simply a weight-loss procedure. Its long-term value should be evaluated not only by changes in weight but also by the durability of metabolic improvements, procedure-specific trade-offs, and the quality of lifelong multidisciplinary follow-up. In current practice, incretin-based pharmacotherapy should be considered as an alternative, adjunct, or sequential strategy in conjunction with MBS.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"15 1","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}