Cirugía Metabólica

1. Cirugía Metabólica
Univ. Ma Teresa Rodríguez
Universidad de Panamá
Facultad de Medicina
Escuela de Medicina
X semestre
Cátedra de Cirugía

2. ¿Es la cirugía
metabólica lo
mismo que
cirugía
bariátrica?
01

3. ¿Es la cirugía metabólica lo
mismo que cirugía bariátrica?
La cirugía bariátrica engloba a la cirugía
metabólica. La cirugía bariátrica es para
todos los pacientes con un peso muy alto
que necesita una cirugía para disminuir su
peso. La cirugía metabólica es usada con la
intención específica de tratar la diabetes y
las disfunciones metabólicas que han
fallado en responder a cambios en estilos
de vida y cambios en medicamentos.
MR SANJAY AGRAWAL, Understanding both metabolic and bariatric surgery, 2020

4. Epidemiología de la
obesidad
La OMS define obesidad como una condición
de excesivo tejido adiposo en el cuerpo al
punto que afecta adversamente la salud y el
bienestar.
El sobrepeso y la obesidad son problemas
crecientes de salud pública tanto en países
desarrollados como no desarrollados
económicamente, con cerca de 1/3 de la
población mundial (1.9 billones de adultos y
niños) con sobrepeso u obesidad.
The ASMBS Textbook of Bariatric Surgery, Second Edition

5. Historia de la cirugía Bariátrica

9. Roux-en-Y (roo-en-wy) gastric bypass.
This procedure is the most common method of gastric bypass.
This surgery is typically not reversible. It works by decreasing the
amount of food you can eat at one sitting and reducing
absorption of fat and calories.
The surgeon cuts across the top of the stomach, sealing it off from the rest of the stomach. The
resulting pouch is about the size of a walnut and can hold only about an ounce of food.
Typically, the stomach can hold about 3 pints of food.
Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch. Food goes
into this small pouch of stomach and then directly into the small intestine sewn to it, bypassing
most of the stomach and the first section of the small intestine. Instead, food goes directly into
the middle part of the small intestine.
The ASMBS Textbook of Bariatric Surgery, Second Edition

10. Sleeve gastrectomy.
Advantages to this procedure include significant weight loss and no rerouting of the
intestines. Sleeve gastrectomy also requires a shorter hospital stay than do most other
procedures.
With sleeve gastrectomy, about 80% of the stomach is removed,
leaving a long, tube-like pouch. This smaller stomach can't hold as
much food. It also produces less of the appetite-regulating hormone
ghrelin, which may lessen the desire to eat.
The ASMBS Textbook of Bariatric Surgery, Second Edition

11. Biliopancreatic diversion with duodenal
switch (BPD/DS)
During the second step, the surgeon closes off the middle section of the intestine and attaches
the last part directly to the first part of the small intestine, called the duodenum. This is the
duodenal switch. The separated section of the intestine isn't removed from the body. Instead,
it's reattached to the end of the intestine, allowing bile and pancreatic digestive juices to flow
into this part of the intestine. This is the biliopancreatic diversion.
This surgery both limits how much you can eat and reduces the absorption of nutrients. While it
is extremely effective, it has greater risk, including malnutrition and vitamin deficiencies.
This is a two-part surgery usually performed in one setting.
The first step involves performing a sleeve gastrectomy.
The ASMBS Textbook of Bariatric Surgery, Second Edition

12. Single-anastomosis duodeno-ileal
bypass with sleeve gastrectomy
(SADI-S).
During the second step of the SADI-S procedure, a section of the small intestine known as
the duodenum is closed off just below the new stomach sleeve. This opening below the new
stomach is then connected to a part of the lower small intestine called the ileum. This is the
duodeno-ileal bypass.
The bypass routes food through only about 10 feet of the small intestine, instead of the usual
25. This means there is less time and distance for the body to absorb fat and calories.
Like BPD/DS, the SADI-S procedure also has two steps, with the
first step being a sleeve gastrectomy.
The ASMBS Textbook of Bariatric Surgery, Second Edition

13. 1. MR SANJAY AGRAWAL, Understanding both metabolic and bariatric surgery,
2020
2. The ASMBS Textbook of Bariatric Surgery, Second Edition
Referencias