SURGICAL APPROACH AND NUTRITIONAL MANAGEMENT IN GASTRIC BYPASS
DOI:
https://doi.org/10.56238/revgeov17n6-029Keywords:
Gastric Bypass, Morbid Obesity, Robotic Surgery, Hypoglycemia, Nutritional ManagementAbstract
Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB) and mini-gastric bypass (MGB), is the most effective treatment for morbid obesity, providing sustained weight loss and remission of comorbidities. This review analyzes surgical approaches, including the robotic technique (RRYGB) which offers greater precision. Postoperative management is crucial due to chronic challenges such as gastrogastric fistula (GGF) and metabolic complications. Of particular note are postprandial hyperinsulinemic hypoglycemia, which requires a low glycemic index diet and pharmacological treatment in refractory cases, and altered alcohol metabolism, which increases the risk of Alcohol Use Disorders (AUD). Continuous nutritional and psychiatric support is essential to optimize overall clinical outcome.
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References
BRIEGLEB, M.; HANAK, C. Gastric bypass and alcohol use: a literature review. Psychiatria Danubina, v. 32, supl. 1, p. 176-179, 2020.
GERMAIN, A.; REIBEL, N.; BRUNAUD, L. Totally robotic gastric bypass. Journal of Visceral Surgery, v. 148, n. 4, p. e267-e272, 2011.
KERSEBAUM, J. N. et al. Robotic Roux-en-Y Gastric Bypass Procedure Guide. JSLS: Journal of the Society of Laparoendoscopic & Robotic Surgeons, v. 24, n. 4, p. e2020.00062, 2020.
NGUYEN, J.; SIKSIK, J. M.; GENSER, L. Gastro-gastric fistula after gastric bypass. Journal of Visceral Surgery, v. 155, n. 5, p. 431-432, 2018.
PATTI, M. E.; GOLDFINE, A. Hypoglycemia after Gastric Bypass: The Dark Side of GLP-1. Gastroenterology, v. 146, n. 3, p. 605-608, 2014.
RUTLEDGE, R.; KULAR, K.; MANCHANDA, N. The Mini-Gastric Bypass original technique. International Journal of Surgery, v. 61, p. 38-41, 2019.
