Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery最新文献

{"title":"Metabolic and bariatric surgery in MAFLD: a meta-analysis of endocrine outcomes, fibrosis remission, and postoperative complications.","authors":"Stylianos Kopanos, Annika Hoyer, Ferdinand Valentin Stoye, Joachim Feldkamp, Sjaak Pouwels, Carolina Pape-Köhler","doi":"10.1016/j.soard.2026.03.020","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.020","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly common among candidates for metabolic and bariatric surgery, yet clinical thresholds defining when surgery is beneficial or contraindicated remain unclear. This systematic review and meta-analysis synthesized evidence from 29 studies including 71,904 patients with biopsy-confirmed or elastography-confirmed MAFLD undergoing sleeve gastrectomy, Roux-en-Y gastric bypass, or other metabolic procedures. Bariatric surgery was associated with marked hepatic and endocrine improvement, with pooled remission rates of 70% for steatohepatitis, 57% for fibrosis, and 59% for type 2 diabetes. Both sleeve gastrectomy and Roux-en-Y gastric bypass achieved comparable metabolic and hepatic benefits, supporting the role of weight-independent mechanisms such as enhanced incretin signaling and improved insulin sensitivity. Postoperative complications occurred in 15% of patients, including 4% major complications, indicating an overall acceptable safety profile. Across studies, patients with compensated cirrhosis experienced meaningful hepatic improvement, whereas those with decompensated cirrhosis, clinically significant portal hypertension, or impaired hepatic reserve had higher morbidity and limited benefit. Endocrine instability-particularly poorly controlled endocrine disease (e.g., uncontrolled diabetes or untreated thyroid dysfunction)-also emerged as a relative contraindication due to impaired healing and unpredictable metabolic responses. These findings underscore the need for careful preoperative evaluation integrating liver staging, endocrine profiling, and metabolic capacity. Overall, bariatric surgery provides substantial hepatic and endocrine benefits for appropriately selected MAFLD patients, while advanced cirrhosis and uncontrolled endocrine disease represent key thresholds at which surgical risk may outweigh benefit. A multidisciplinary liver-endocrine approach is essential for optimal candidate selection and postoperative outcomes.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bariatric surgery on pelvic floor dysfunction symptoms: a systematic review and meta-analysis of prospective Studies.","authors":"Alireza Hadizadeh, Henry H Chill, Angela Leffelman, Ana Burgos, Cecilia Chang, Jungeun Lee, Claudia Paya-Ten, Roger P Goldberg, Steven D Abramowitch, Ghazaleh Rostaminia, Stephen P Haggerty","doi":"10.1016/j.soard.2026.03.018","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.018","url":null,"abstract":"<p><p>Pelvic floor dysfunction (PFD), including urinary incontinence (UI), pelvic organ prolapse (POP), and fecal incontinence (FI), is highly prevalent among women and strongly linked to obesity. Given the mechanical and physiological effects of excess weight on pelvic floor support, weight loss via bariatric surgery may improve PFD symptoms. This systematic review and meta-analysis aimed to evaluate the impact of bariatric surgery on PFD outcomes, based on 32 prospective studies encompassing 5299 patients. Following surgery, the mean body mass index decreased by 12.26 kg/m². UI prevalence declined by 50%, with significant improvements in both stress and urge UI. POP symptoms also significantly improved, while FI outcomes remained unchanged. Quality of life measures such as Pelvic Floor Distress Inventory-20, Incontinence Questionnaire-Short Form, and Pelvic Floor Impact Questionnaire-7 showed notable improvement, though no significant change was observed in PISQ-12 scores. These findings underscore the beneficial effects of bariatric surgery on urinary and prolapse symptoms, supporting its role in the multidisciplinary management of obesity-related PFD.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationships between maternal nutritional and metabolic parameters and birth weight differ after Roux-en-Y gastric bypass and sleeve gastrectomy.","authors":"Muriel Coupaye, Aude Pacheco, Violaine Peyronnet, Ouidad Sami, Thierry Dupré, Thibaud Lefebvre, Suzette Coelho, David Moszkowicz, Laurent Mandelbrot, Séverine Ledoux","doi":"10.1016/j.soard.2026.03.019","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.019","url":null,"abstract":"<p><strong>Background: </strong>Factors influencing fetal growth after metabolic bariatric surgery remain to be clarified.</p><p><strong>Objectives: </strong>To evaluate the relationships between birth weight (BW) and maternal nutritional and metabolic parameters after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).</p><p><strong>Setting: </strong>University Hospital, France.</p><p><strong>Methods: </strong>Women with a singleton pregnancy who underwent at least one second-trimester nutritional assessment at our institution between 2006 and 2022 were included. Associations between maternal parameters and BW adjusted for sex and gestational age (Z-score) were studied.</p><p><strong>Results: </strong>A total of 155 pregnancies were studied, 71 after RYGB and 84 after SG. Although postoperative weight loss was greater after RYGB, maternal characteristics before pregnancy were comparable. The number of nutritional deficiencies was similar but women after RYGB took more nutritional supplements, while gestational weight gain was greater after SG. Mean BW (3095 ± 628 g versus 3184 ± 516 g) and the proportion of small-for-gestational-age (SGA) newborns (24% versus 21%) were similar between procedures. No association was observed between nutritional deficits and BW. After RYGB, serum iron parameters were negatively correlated with BW Z-score, while fasting glucose and insulin concentrations were positively correlated (P < .01). No significant associations were identified after SG.</p><p><strong>Conclusions: </strong>Despite a similar risk of SGA, the maternal determinants of BW differ between RYGB and SG. Metabolic parameters appear to be involved after RYGB but not after SG, whereas nutritional deficiencies do not seem to be associated with BW. Additional maternal factors, particularly after SG, should be investigated to explain the increased risk of SGA.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic primary Roux-en-Y gastric bypass is independently associated with increased 30-day mortality: a 2023 MBSAQIP analysis of 50,365 patients.","authors":"Valentin Mocanu, Mélissa V Wills, Salvador Navarrete, Pattharasai Kachornvitaya, Xinlei Zhu, Andrew Strong, Matthew Kroh, Jerry Dang, Salvador Navarrete","doi":"10.1016/j.soard.2026.03.014","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.014","url":null,"abstract":"<p><strong>Background: </strong>The implementation of robotic Roux-en-Y gastric bypass (R-RYGB) has been met with tremendous enthusiasm over the last decade. Yet, despite the rapidly increasing adoption of robotic delivery, remarkably little is known about the impact of modern R-RYGB on short-term morbidity and mortality.</p><p><strong>Objectives: </strong>The objective of this study was to characterize and evaluate differences in 30-day morbidity and mortality between patients receiving elective RYGB cases through either laparoscopic or robotic approaches in 2023.</p><p><strong>Setting: </strong>All participating Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) centers entering data in the most recent 2023 operative year.</p><p><strong>Methods: </strong>A retrospective analysis of the 2023 MBSAQIP database was performed by identifying all elective primary laparoscopic (L-RYGB) and robotic RYGB cases. Bivariate analysis was conducted using either χ² tests or Wilcoxon rank sum tests as appropriate. Multivariable logistic regression analysis was then used to identify independent predictors of morbidity and mortality.</p><p><strong>Results: </strong>A total of 50,365 patients underwent RYGB, of whom 19,553 (38.8%) received R-RYGB. There were no clinically relevant differences with respect to age (44.6 ± 11.6 R-RYGB versus 44.4 ± 11.5 L-RYGB; P = .05), body mass index (45.6 ± 7.8 R-RYGB versus 45.3 ± 7.5 L-RYGB; P < .0001), or female sex (83.1% R-RYGB versus 83.3% L-RYGB; P = .6) between cohorts. R-RYGB patients were more likely to have reflux (46.4% versus 41.6%; P < .0001), undergo concurrent paraesophageal hernia repair (19.4% versus 15.8%; P < .0001), and have increased operative length (139.7 ± 55.5 min versus 115.2 ± 53.7 min; P < .0001). L-RYGB patients had higher rates of bleeding (1.5% versus 1.2%; P = .001), whereas R-RYGB patients had higher 30-day rates of readmission (5.3% versus 4.3%; P < .0001), cardiac events (.2% versus .1%; P = .005), and mortality (.14% versus .07%; P = .02%). After adjusting for patient and technical factors, robotic delivery was independently associated with increased mortality (odds ratio: 2.10; 95% confidence interval: 1.11-3.96; P = .02).</p><p><strong>Conclusion: </strong>In 2023, robotic RYGB comprised only 39% of elective cases yet over one half of all deaths occurring within 30 days. Multivariable regression demonstrated a 2-fold increased mortality associated with robotic delivery. Caution should be employed as robotic approaches become increasingly adopted with emphasis made on training standardization and center accreditation.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International expert consensus on definitions and management of weight recurrence and suboptimal response after metabolic and bariatric surgery: a Delphi study.","authors":"Mélissa V Wills, Sol Lee, Valentin Mocanu, Yung Lee, Pattharasai Kachornvitaya, Xinlei Zhu, Nasreen Alfaris, Laura Andromalos, Caroline Apovian, Estuardo Behrens, Dieter Birk, Luca Busetto, Anita Courcoulas, David Cummings, Silvia Leite Faria, Omar Ghanem, Sang-Moon Han, Shahzeer Karmali, Lee Kaplan, Lilian Kow, Carel W le Roux, Kamal Mahawar, Khaled Gawdat, Rodrigo Munoz, Mario Musella, Abdelrahman Nimeri, Mary O'Kane, Mariano Palermo, Guillermo Ponce de Leon Ballesteros, Paulina Salminen, Shelby Sullivan, Suthep Udomsawaengsup, Colleen Tewksbury, Josep Vidal, John Wilding, Jerry Dang, Andrew Strong, Salvador Navarrete, Natan Zundel, Mohammad Kermansaravi, Scott Butsch, Matthew Kroh, Ricard Corcelles","doi":"10.1016/j.soard.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.006","url":null,"abstract":"<p><strong>Background: </strong>Weight recurrence and suboptimal response after metabolic and bariatric surgery (MBS) lack standardized definitions and management approaches, creating barriers to evidence-based treatment decisions and coordinated care across multiple specialties.</p><p><strong>Objectives: </strong>To establish international expert consensus on terminology, diagnostic approaches, and management strategies for suboptimal response and weight recurrence after MBS.</p><p><strong>Setting: </strong>International Delphi study across multiple countries and health care systems.</p><p><strong>Methods: </strong>A two-round modified Delphi study was conducted with 66 international experts across five specialties (MBS, obesity medicine, gastroenterology, endocrinology, dietetics and nutrition, and psychology). A 164-item questionnaire was developed, spanning seven dimensions: conservative management, diagnostic methods, endoscopic interventions, quantitative thresholds, risk factors, surgical interventions, and terminology. Consensus was defined a priori as ≥70% agreement. Inter-rater reliability was assessed using Gwet's AC1 coefficient.</p><p><strong>Results: </strong>Response rates were 54.5% (Round 1) and 57.6% (Round 2). Consensus achievement improved significantly between rounds (26.2% to 40.9% of items). Experts reached unanimous agreement on core management principles including individualized patient care (100%) and the appropriateness of specialists prescribing antiobesity medications (100%). Strong consensus emerged on standardized terminology with \"suboptimal\" as the preferred term (89.5%) and %TWL as the optimal measurement approach (94.6). For quantitative thresholds, consensus was achieved on surgical nonresponse defined as <10% TWL at 12 months (73.0%), recurrent weight gain as >25% of lost weight from nadir (70.3%), and a 10% change in %EWL from nadir as normal physiologic response (83.8%). Conservative management items achieved the highest consensus rates (80.9%) while quantitative threshold items require additional research (28.1%). Inter-rater reliability improved across all domains, with conservative management achieving substantial agreement (AC1 = .70).</p><p><strong>Conclusion: </strong>Expert consensus was achieved on fundamental principles of postbariatric care, including preferred terminology, measurement metrics, and provider roles. These recommendations address important gaps in clinical practice standardization.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic metabolic and bariatric surgery in patients with high body mass index-a nationwide registry-based cohort study.","authors":"Erik Stenberg, Magnus Sundbom, Suzanne Hedberg, Johan Ottosson, Erik Näslund","doi":"10.1016/j.soard.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.012","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) can be challenging in patients with a very high body mass index (BMI).</p><p><strong>Objectives: </strong>The objective of the study is to evaluate the outcomes of different weight categories in a publicly funded healthcare system with high adherence to current guidelines for perioperative optimization.</p><p><strong>Setting: </strong>Nationwide, registry-based.</p><p><strong>Methods: </strong>Based on nationwide data from the Scandinavian Obesity Surgery Registry, patients operated on with Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch (BPD/DS) from 2007 until 2024 were included. Patients were stratified according to preoperative BMIs of 35-49 kg/m², 50-59 kg/m², 60-69 kg/m², and ≥70 kg/m².</p><p><strong>Results: </strong>The study included data for 83,057 patients. A postoperative complication occurred for 5855 (7.2%) with no difference between BMI groups. Operation time was longer for higher BMI groups for all procedures. At 2 years, patients lost the highest percentage of their total weight (%TWL) in all BMI categories after BPD/DS (37.9% ± 10.1% to 45.4% ± 15.3%), followed by RYGB (32.4% ± 8.6% to 36.8% ± 10.9%) and SG (26.6% ± 9.5% to 31.3% ± 8.9%). Mortality rates over a median of 9.8 years remained higher in the higher BMI groups (BMI: 50-59, odds ratio [OR] = 1.29 [1.15-1.46]; BMI: 60-69, OR = 1.66 [1.18-2.33]; BMI ≥70, OR = 2.33 [.96-5.68]).</p><p><strong>Conclusion: </strong>MBS can be performed safely in patients with obesity class 4 or higher. Higher BMI was associated with longer operating times and superior weight loss, especially after BPD/DS. Despite greater weight loss and similar remission of metabolic co-morbid diseases, patients with higher preoperative BMI still have an increased long-term risk of all-cause mortality.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Prevalence of early marginal ulcer in sleeve to bypass conversions: an analysis of the 2020-2022 MBSAQIP.","authors":"Sean M O'Neill, Michael A Kia","doi":"10.1016/j.soard.2026.03.017","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.017","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude and durability of hormonal adaptations after bariatric surgery: a dose response meta-analysis.","authors":"Mohamed Badie Ahmed, Youssuf Khanafer, Mohamed A Abdelsalam, Ayman Dalol, Humam Emad Rajha, Asma Syed, Aly Mostafa Hassan, Salwa Al-Maraghi, Khaled E Elzawawi, Abeer Alsherawi, Mazen Hassanain, Suhail A Doi, Abdella M Habib","doi":"10.1016/j.soard.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.011","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery induces metabolic improvements that extend beyond weight loss, yet the hormonal dynamic underlying these effects remain incompletely characterized. Previous meta-analyses have relied on static comparisons of hormone levels, limiting insight into the temporal dynamics of endocrine adaptation.</p><p><strong>Objectives: </strong>To quantify the magnitude and durability of hormonal changes following bariatric surgery and to elucidate how these shifts may refine procedure selection and identify key metabolic pathways.</p><p><strong>Setting: </strong>Not applicable, as this dose-response meta-analysis (DRMA) synthesized data from previously published studies.</p><p><strong>Methods: </strong>We conducted a DRMA of 59 studies to model postoperative trajectories of six hormones: glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP), PYY, leptin, adiponectin, and ghrelin after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).</p><p><strong>Results: </strong>RYGB led to sustained increases in GLP-1 and PYY and a steady decline in GIP, while SG produced durable suppression of ghrelin and an earlier rise in adiponectin. Leptin declined after both procedures, with a greater drop post-RYGB. Several hormones exhibited nonlinear trends, highlighting the importance of evaluating the durability and timing of postoperative hormonal responses.</p><p><strong>Conclusion: </strong>RYGB and SG elicit distinct and durable postoperative hormonal trajectories over time, reflecting divergent physiological mechanisms. These profiles may help guide procedure selection according to metabolic characteristics and support the use of endocrine markers to improve long-term outcomes.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight on postoperative conversion trends in elderly bariatric patients: a MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program) analysis.","authors":"Juan S Barajas-Gamboa, Gabriela Restrepo-Rodas, Valentin Mocanu, Thomas H Shin, Gustavo Romero-Velez, Andrew T Strong, Salvador Navarrete, John Rodriguez, Ricard Corcelles, Matthew Kroh, Jerry T Dang","doi":"10.1016/j.soard.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.007","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of post-bariatric hypoglycemia in the United States.","authors":"Colleen M Craig, Suruchi Ramanujan, Tracey L McLaughlin","doi":"10.1016/j.soard.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.soard.2026.03.013","url":null,"abstract":"<p><strong>Background: </strong>Post-bariatric hypoglycemia (PBH) is a complication of bariatric surgery in which postprandial hypoglycemia can be severe, frequent, and debilitating. The incidence reported in the literature varies from .1% to 75% of all bariatric procedures, largely due to differences in methodologies and definitions used to identify incident cases.</p><p><strong>Objectives/methods: </strong>To define the burden of PBH, the incidence and prevalence must be ascertained, with accurate definitions of incident cases used. We performed a systematic review of published literature with the following goals: 1) Outline differences between methodologies and definitions used to determine incidence of PBH; 2) Suggest optimal parameters (Level A criteria) to use in defining incident cases; 3) Suggest PBH disease severity classification system; 4) Estimate incidence by severity level based on studies meeting Level A criteria; 5) Model current U.S. prevalence based on incidence rates, surgical census data, and life-expectancy data.</p><p><strong>Results: </strong>Based on our Level A studies analysis, nearly 30% of Roux-en-Y gastric bypass (RYGB) patients and 10% of sleeve gastrectomy (SG) patients develop hypoglycemia after surgery, with 12% of RYGB and 5% of SG patients requiring medical attention. This translates to approximately 160,000 requiring medical management and over 30,000 receiving critical care.</p><p><strong>Conclusion: </strong>This significant burden, together with the highly conflicting incidence estimates in published studies underscores the pressing need for standardized assessment methods that will pave the way for improved quality of research, estimates of health care needs and cost, and development of effective treatments.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}