Malabsorption contre restriction en chirurgie de l’obésité: un débat dépassé ?

Abstract

Several facts tell us that the difference between malabsorptive and restrictive surgeries is no longer relevant in bariatric surgery, which include technical and strategic points. Technical points: some procedures do not fit in the classification, and a restrictive component is mandatory in all operations. Strategic points: step-to-step procedures entail a sequence of restriction, followed by malabsorption; the debate over the surgical approach is predominant (noninvasive channels); acceptability and feasibility of widespread procedures are not in favor of malabsorption at times of “epidemic obesity.” Besides, one may question the results that are supposedly obtained from malabsorptive surgery. Eventually, the argument of “time saving” must prevail: simple and non invasive restriction with diet counselling should be the best option for obese patients in the future.