To provide a systematic overview of metabolic surgical procedures for managing type 2 diabetes mellitus (T2DM), comparing their efficacy and examining associated complications.
Approach:
Surgical Procedures Overview: The review discusses Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch (BPD/DS), along with their therapeutic efficacy and complications.
Efficacy Evaluation: The review evaluates the long-term postoperative effectiveness and preoperative predictors of surgical outcomes.
Key Findings:
RYGB can achieve complete remission of T2DM in 65.2% of patients within six months postoperatively.
Long-term follow-up shows 60%-80% excess weight loss one year after RYGB, with mean BMI decreasing from 40 kg/m² to approximately 28-30 kg/m².
Metabolic effects of RYGB are linked to changes in gut hormone secretion and gut microbiota composition.
Interpretation:
Metabolic surgery, particularly RYGB, shows significant potential in managing T2DM and obesity, but concerns about postoperative diabetes recurrence and complications remain.
