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Die Chirurgie
Erschienen in: Der Chirurg 2/2019

01.02.2019 | Konservative Therapie | CME

Metabolische Chirurgie

verfasst von: PD Dr. Dr. A. T. Billeter, Prof. Dr. B. P. Müller-Stich

Erschienen in: Die Chirurgie | Ausgabe 2/2019

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Zusammenfassung

Die chirurgische Therapie metabolischer Erkrankungen hat sich in den letzten Jahren als effektive Alternative zur konservativen Therapie etabliert. Die neuen S3-Leitlinien adressieren diese Veränderungen und geben klare Indikationen für die Adipositaschirurgie. Einer der Kernpunkte der neuen Leitlinien stellt die Unterscheidung der Adipositaschirurgie von der metabolischen Chirurgie dar. Bei der Adipositaschirurgie ist der Gewichtsverlust das primäre Therapieziel, während es bei den metabolischen Indikationen die Verbesserung der Komorbidität unabhängig vom BMI ist. Bezüglich der Verfahrensauswahl können die SG und der traditionelle RYGB als sichere und mit harter Evidenz belegte Operationen angewandt werden. Der RYGB hat bessere metabolische Effekte bei jedoch auch höheren Komplikations- und Reinterventionsraten. Neuere Verfahren wie der „one anastomosis gastric bypass“ oder der „single anastomosis duodeno-ileal“ haben möglicherweise leicht stärkere metabolische Effekte, wobei allerdings auch das Risiko für Mangelernährung und Vitaminmängel höher ist.
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Metadaten
Titel
Metabolische Chirurgie
verfasst von
PD Dr. Dr. A. T. Billeter
Prof. Dr. B. P. Müller-Stich
Publikationsdatum
01.02.2019
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 2/2019
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-018-0786-z

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