[Surgical treatment of morbid obesity].
BACKGROUND
Patients with morbid obesity are prone to weight-related disease, reduced quality of life and shortened life expectancy. Long-term weight loss is unsatisfactory with conservative treatment and weight-reducing surgery is increasingly performed in all Norwegian health regions.


METHODS
This review is based on electronic database searches. We describe the two procedures most commonly performed in Norway, i.e. gastric bypass and biliopancreatic diversion with duodenal switch, including preoperative workup and expected results after surgery. The domestic use of different surgical techniques is also outlined.


RESULTS
In Norway, around 750 bariatric procedures were planned in 2006. Gastric bypass yields a weight reduction of 30% two years after the operative. Resolution of type 2-diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea has been demonstrated in most patients. A majority of patients report improved quality of life. Procedure-related mortality is less than 1% and surgical complications occur in approximately 20%. Nutritional deficiencies are frequent. Weight loss is somewhat greater after biliopancreatic diversion with duodenal switch, but the procedure is more complex. Life-long follow-up is recommended after bariatric surgery.


CONCLUSIONS
In selected patients with morbid obesity, bariatric surgery is a viable treatment. However, prospective long- term studies are needed.
Aasheim
Erlend T
ET
Medisinsk klinikk, Aker universitetssykehus, 0514 Oslo. e.t.aasheim@medisin.uio.no
Mala
Tom
T
Søvik
Torgeir T
TT
Kristinsson
Jon
J
Bøhmer
Thomas
T
D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015904:Biliopancreatic Diversion / Q000379:methods; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome