Actualización de cirugía bariátrica y cirugía metabólica

Autores/as

  • Graciela Álvarez Universidad Favaloro, Centro de Estudio y Tratamiento de la Obesidad Severa (CETOS), Ciudad Autónoma de Buenos Aires, Argentina
  • Susana Fuentes Hospital de Alta Complejidad El Cruce, Florencio Varela, Provincia de Buenos Aires, Argentina
  • Juliana Mociulsky Instituto Cardiovascular Buenos Aires ICBA, Ciudad Autónoma de Buenos Aires, Argentina
  • María Victoria Salinas Clínica Médica y Nutrición, Ciudad Autónoma de Buenos Aires, Argentina
  • María Yuma Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Susana Gutt Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Marianela Ackerman Área Diabetes y Nutrición, Centro Integral de Endocrinología y Nutrición (CIEN), Corrientes, Argentina
  • Paula Lifszyc Hospital Carlos Durand, Ciudad Autónoma de Buenos Aires, Argentina
  • Frank Espinoza Instituto Cardiovascular Lezica, Martínez, Provincia de Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v47i3.211

Palabras clave:

diabetes tipo 2, obesidad mórbida, cirugía bariátrica, cirugía metabólica

Resumen

La obesidad aumenta el riesgo de desarrollar o agravar múltiples afecciones particularmente la diabetes tipo 2, una enfermedad crónica de difícil control cuyo tratamiento con distintos fármacos y aún con insulina, frecuentemente no alcanza los objetivos terapéuticos ni reduce el riesgo cardiovascular. Cuando se asocia a obesidad severa, su terapéutica se torna más compleja. Se analiza la utilización de cirugía bariátrica y metabólica en pacientes con obesidad severa y diabetes, se revisan las técnicas quirúrgicas, las hipótesis sobre su mecanismo de acción, la selección de pacientes y los resultados. La cirugía bariátrica ha probado ser efectiva en el tratamiento de la obesidad severa y de la DM2 en pacientes con IMC >35 kg/m2. Es una cirugía de aceptable tolerancia en personas preparadas, de bajo riesgo y con complicaciones subsanables y manejables en la actualidad. La cirugía bariátrica dispone de suficiente respaldo científico. En cambio, en las evidencias disponibles de la cirugía metabólica en pacientes con IMC <35 kg/m2 y más aún con IMC <30 kg/m2 existen resultados promisorios en el corto y mediano plazo, pero no se dispone aún de evidencia suficiente que avale su indicación. Se requieren más investigaciones para establecer la eficacia y seguridad de estas técnicas quirúrgicas en el largo plazo.

Biografía del autor/a

Graciela Álvarez, Universidad Favaloro, Centro de Estudio y Tratamiento de la Obesidad Severa (CETOS), Ciudad Autónoma de Buenos Aires, Argentina

Clínica Médica; Especialista en Nutrición con orientación en Obesidad; Docente de la Universidad Favaloro; Médica Clínica y Nutricionista del Centro de Estudio y Tratamiento de la Obesidad Severa (CETOS)

Susana Fuentes, Hospital de Alta Complejidad El Cruce, Florencio Varela, Provincia de Buenos Aires, Argentina

Médica Especialista en Clínica Médica y Diabetes; Equipo Cirugía Bariátrica y Metabólica, Hospital de Alta Complejidad El Cruce

Juliana Mociulsky, Instituto Cardiovascular Buenos Aires ICBA, Ciudad Autónoma de Buenos Aires, Argentina

Médica Endocrinóloga; Jefa de la Unidad Nutrición, Instituto Cardiovascular Buenos Aires ICBA

María Victoria Salinas, Clínica Médica y Nutrición, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Clínica y Nutrición

María Yuma, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición

Susana Gutt, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición; Jefa de Nutrición

Marianela Ackerman, Área Diabetes y Nutrición, Centro Integral de Endocrinología y Nutrición (CIEN), Corrientes, Argentina

Médica especialista en Medicina Interna y Nutrición, Magister en Diabetes; Directora del área Diabetes y Nutrición Centro Integral de Endocrinología y Nutrición (CIEN)

Paula Lifszyc, Hospital Carlos Durand, Ciudad Autónoma de Buenos Aires, Argentina

Médica de Planta de la Unidad de Nutrición del Hospital Carlos Durand

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Publicado

10-01-2023

Cómo citar

Álvarez, G., Fuentes, S., Mociulsky, J., Salinas, M. V., Yuma, M., Gutt, S., Ackerman, M., Lifszyc, P., & Espinoza, F. (2023). Actualización de cirugía bariátrica y cirugía metabólica. Revista De La Sociedad Argentina De Diabetes, 47(3), 69–80. https://doi.org/10.47196/diab.v47i3.211

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