La chirurgie de l'obésité a-t-elle une place ?

Abstract

In France the prevalence of obesity is less than in United-State, England or Eastern Europe, but there are a progressive augmentation, specially in 35–55 years old people and in the North and East of France, in cities and in the poor localisations. Careful patient selection and preoperative work-up are extremely important and are now very well codified by ANAES recommendations that are carefully follow up by national social security. A number of medical comorbidities are improved after surgically-induced weight loss. If the patient cannot lose weight with traditional methods, because of morbidity and late term complications, surgery should be considered. Bariatric surgery is most time a safe and effective method for achieving durable weight loss for patients with morbid obesity. Different intervention could be realized. Gastric restrictive procedures include vertical banded gastroplasty and gastric banding. Malabsorptive procedures include long-limb gastric bypass, biliopancreatic diversion, and biliopancreatic diversion with duodenal switch. Adverse events have been reported for all kind of surgery. A careful selection of the patients should be done to minimized the complications after surgery.