Профилактика и лечение отдельных желудочно- кишечных осложнений после бариатрической хирургии

Ильчишина Т.А., Кучерявый Ю.А., Свиридова Т.Н. Профилактика и лечение отдельных желудочно-кишечных осложнений после бариатрической хирургии. Consilium Medicum. 2022;24(5):312–316.
DOI: 10.26442/20751753.2022.5.201731

© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.

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Ilchishina TA, Kucheryavyy YuA, Sviridova TN. Prevention and treatment of some gastrointestinal complications after bariatric surgery: A review. Consilium Medicum. 2022;24(5):312–316.
DOI: 10.26442/20751753.2022.5.201731

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Аннотация

Во всем мире процент людей, страдающих избыточной массой тела, растет каждый год, а врачи говорят об эпидемии ожирения. В настоящее время наблюдается глобальное увеличение количества процедур бариатрической хирургии как единственного эффективного подхода при патологически высоком весе. Однако с расширением показаний к бариатрической хирургии и ростом количества проводимых вмешательств по поводу ожирения закономерно увеличивается количество публикаций о периоперационных, послеоперационных и поздних осложнениях операций.

Ключевые слова: ожирение, бариатрическая хирургия, ингибиторы протонной помпы, урсодезоксихолевая кислота, синдром избыточного бактериального роста, панкреатическая недостаточность

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Globally, the incidence of overweight is increasing every year, and doctors around the world are talking about an epidemic of obesity. There has been a significant increase in bariatric surgery procedures as the only effective approach for morbid obesity. However, as the indications for bariatric surgery expand and the number of procedures increases, the number of publications on perioperative, postoperative, and late complications of surgery naturally increases.

Keywords: obesity, bariatric surgery, proton pump inhibitors, ursodeoxycholic acid, bacterial overgrowth syndrome, pancreatic insufficiency

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Список литературы

1. Алфёрова В.И., Мустафина С.В. Распространенность ожирения во взрослой популяции Российской Федерации (обзор литературы). Ожирение и метаболизм. 2022;19(1):96‑105 [Alferova VI, Mustafina SV. The prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and metabolism. 2022;19(1):96-105 (in Russian)]. DOI:10.14341/omet12809
2. Российская ассоциация эндокринологов, Общество бариатрических хирургов. Клинические рекомендации 2022. Ожирение. Режим доступа: https://cr.minzdrav.gov.ru/schema/28_2/ Ссылка активна на 13.06.2022 [Rossiiskaia assotsiatsiia endokrinologov, Obshchestvo bariatricheskikh khirurgov. Klinicheskie rekomendatsii 2022. Ozhirenie. Available at: https://cr.minzdrav.gov.ru/schema/28_2/ Accessed: 13.06.2022 (in Russian)].
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5. Stenberg E, dos Reis Falcão LF, O'Kane M, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022;46:729-51. DOI:10.1007/s00268-021-06394-9
6. Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022;117(1):27-56. DOI:10.14309/ajg.0000000000001538
7. Ивашкин В.Т., Маев И.В., Трухманов А.С., и др. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению гастроэзофагеальной рефлюксной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020;30(4):70-97 [Ivashkin VT, Maev IV, Trukhmanov AS, et al. Recommendations of the Russian Gastroenterological Association in Diagnosis and Treatment of Gastroesophageal Reflux Disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(4):70-97 (in Russian)]. DOI:10.22416/1382-4376-2020-30-4-70-97
8. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists – executive summary. Endocr Pract. 2019;25(12):1346-59. DOI:10.4158/GL-2019-0406
9. Collares-Pelizaro RVA, Santos JS, Nonino CB, et al. Omeprazole Absorption and Fasting Gastrinemia After Roux-en-Y Gastric Bypass. Obes Surg. 2017;27(9):2303-7. DOI:10.1007/s11695-017-2672-z
10. Schulman AR, Chan WW, Devery A, et al. Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared With Intact Capsules for Marginal Ulceration Following Roux-en-Y Gastric Bypass. Clin Gastroenterol Hepatol. 2017;15(4):494-500.e1. DOI:10.1016/j.cgh.2016.10.015
11. Magouliotis DE, Tasiopoulou VS, Svokos AA, et al. Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: an updated systematic review and meta-analysis. Obes Surg. 2017;27(11):3021-30. DOI:10.1007/s11695-017-2924-y
12. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146-81. DOI:10.1016/j.jhep.2016.03.005
13. Haal S, Guman MSS, Boerlage TCC, et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol. 2021;6(12):993-1001. DOI:10.1016/s2468-1253(21)00301-0
14. Dolan RD, Baker J, Harer K, et al. Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass. Obes Surg. 2021;31(2):564-9. DOI:10.1007/s11695-020-05032-y
15. Kaniel O, Sherf-Dagan S, Szold A, et al. The Effects of One Anastomosis Gastric Bypass Surgery on the Gastrointestinal Tract. Nutrients. 2022;14(2):304. DOI:10.3390/nu14020304
16. Lakhani SV, Shah HN, Alexander K, et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res. 2008;28(5):293-8. DOI:10.1016/j.nutres.2008.03.002
17. Lauritano EC, Gabrielli M, Scarpellini E, et al. Antibiotic therapy in small intestinal bacterial overgrowth: rifaximin versus metronidazole. Eur Rev Med Pharmacol Sci. 2009;13(2):111-6.
18. Vujasinovic M, Valente R, Thorell A, et al. Pancreatic Exocrine Insufficiency after Bariatric Surgery. Nutrients. 2017;9(11):1241. DOI:10.3390/nu9111241
19. Brunet E, Caixàs A, Puig V. Review of the management of diarrhea syndrome after a bariatric surgery. Endocrinol Diabetes Nutr (Engl Ed). 2020;67(6):401-7. DOI:10.1016/j.endinu.2019.09.013
20. Ozmen MM, Gundogdu E, Guldogan CE, Ozmen F. The Effect of Bariatric Surgery on Exocrine Pancreatic Function. Obes Surg. 2021;31(2):580-7. DOI:10.1007/s11695-020-04950-1
21. Chaudhary A, Domínguez-Muñoz JE, Layer P, Lerch MM. Pancreatic Exocrine Insufficiency as a Complication of Gastrointestinal Surgery and the Impact of Pancreatic Enzyme Replacement Therapy. Dig Dis. 2020;38(1):53-68. DOI:10.1159/000501675
22. Scarpellini E, Arts J, Karamanolis G, et al. International consensus on the diagnosis and management of dumping syndrome. Nat Rev Endocrinol. 2020;16(8):448-66. DOI:10.1038/s41574-020-0357-5
23. Moreira RO, Moreira RB, Machado NA, et al. Postp-randial hypoglycemia after bariatric surgery pharmacological treatment with verapamil and acarbose. Obes Surg. 2008;18(12):1618-21. DOI:10.1007/s11695-008-9569-9
24. Mundi MS, Vallumsetla N, Davidson JB, et al. Use of home parenteral nutrition in post-bariatric surgery-related malnutrition. JPEN J Parenter Enteral Nutr. 2017;41(7):1119-24. DOI:10.1177/0148607116649222
25. Jeppesen PB, Gabe SM, Seidner DL, et al. Factors Associated With Response to Teduglutide in Patients With Short-Bowel Syndrome and Intestinal Failure. Gastroenterology. 2018;154(4):874-85. DOI:10.1053/j.gastro.2017.11.023
26. Afshar S, Kelly SB, Seymour K, et al. The Effects of Bariatric Procedures on Bowel Habit. Obes Surg. 2016;26(10):2348-54. DOI:10.1007/s11695-016-2100-9
27. Scientific Advisory Committee on Nutrition. Carbohydrates and Health Report. 2015. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/4455... Accessed: 13.06.2022.
28. Ivezaj V, Benoit SC, Davis J, et al. Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms. Curr Psychiatry Rep. 2019;21(9):85. DOI:10.1007/s11920-019-1070-8
29. Ibrahim N, Alameddine M, Brennan J, et al. New onset alcohol use disorder following bariatric surgery. Surg Endosc. 2019;33(8):2521-30. DOI:10.1007/s00464-018-6545-x
30. Mellinger JL, Shedden K, Winder GS, et al. Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse. Liver Int. 2021;41(5):1012-19. DOI:10.1111/liv.14805
31. Acevedo MB, Eagon JC, Bartholow BD, et al. Sleeve gastrectomy surgery: when 2 alcoholic drinks are converted to 4. Surg Obes Relat Dis. 2018;14(3):277-83. DOI:10.1016/j.soard.2017.11.010
32. Acevedo MB, Teran-Garcia M, Bucholz KK, et al. Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study. Surg Obes Relat Dis. 2020;16(4):536-44. DOI:10.1016/j.soard.2020.01.014
33. Yska JP, Gertsen S, Flapper G, et al. NSAID Use after Bariatric Surgery: a Randomized Controlled Intervention Study. Obes Surg. 2016;26(12):2880-5. DOI:10.1007/s11695-016-2218-9
34. Begian A, Samaan JS, Hawley L, et al. The use of nonsteroidal anti-inflammatory drugs after sleeve gastrectomy. Surg Obes Relat Dis. 2021;17(3):484-8. DOI:10.1016/j.soard.2020.11.016

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1. Alferova VI, Mustafina SV. The prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and metabolism. 2022;19(1):96-105 (in Russian). DOI:10.14341/omet12809
2. Rossiiskaia assotsiatsiia endokrinologov, Obshchestvo bariatricheskikh khirurgov. Klinicheskie rekomendatsii 2022. Ozhirenie. Available at: https://cr.minzdrav.gov.ru/schema/28_2/ Accessed: 13.06.2022 (in Russian).
3. Drapkina OM, Samorodskaia IV, Starinskaia MA, et al. Ozhirenie: otsenka i taktika vedeniia patsientov. Kollektivnaia monografiia. Moscow: FGBU NMITs TPM Minzdrava Rossii; Silitseia-Poligraf, 2021, p. 174 (in Russian).
4. Wennerlund J, Gunnarsson U, Strigård K, Sundbom M. Acid-related complications after laparoscopic Roux-en-Y gastric bypass: risk factors and impact of proton pump inhibitors. Surg Obes Relat Dis. 2020;16(5):620‑5. DOI:0.1016/j.soard.2020.01.005
5. Stenberg E, dos Reis Falcão LF, O'Kane M, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022;46:729-51. DOI:10.1007/s00268-021-06394-9
6. Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022;117(1):27-56. DOI:10.14309/ajg.0000000000001538
7. Ivashkin VT, Maev IV, Trukhmanov AS, et al. Recommendations of the Russian Gastroenterological Association in Diagnosis and Treatment of Gastroesophageal Reflux Disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(4):70-97 (in Russian). DOI:10.22416/1382-4376-2020-30-4-70-97
8. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists – executive summary. Endocr Pract. 2019;25(12):1346-59. DOI:10.4158/GL-2019-0406
9. Collares-Pelizaro RVA, Santos JS, Nonino CB, et al. Omeprazole Absorption and Fasting Gastrinemia After Roux-en-Y Gastric Bypass. Obes Surg. 2017;27(9):2303-7. DOI:10.1007/s11695-017-2672-z
10. Schulman AR, Chan WW, Devery A, et al. Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared With Intact Capsules for Marginal Ulceration Following Roux-en-Y Gastric Bypass. Clin Gastroenterol Hepatol. 2017;15(4):494-500.e1. DOI:10.1016/j.cgh.2016.10.015
11. Magouliotis DE, Tasiopoulou VS, Svokos AA, et al. Ursodeoxycholic acid in the prevention of gallstone formation after bariatric surgery: an updated systematic review and meta-analysis. Obes Surg. 2017;27(11):3021-30. DOI:10.1007/s11695-017-2924-y
12. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146-81. DOI:10.1016/j.jhep.2016.03.005
13. Haal S, Guman MSS, Boerlage TCC, et al. Ursodeoxycholic acid for the prevention of symptomatic gallstone disease after bariatric surgery (UPGRADE): a multicentre, double-blind, randomised, placebo-controlled superiority trial. Lancet Gastroenterol Hepatol. 2021;6(12):993-1001. DOI:10.1016/s2468-1253(21)00301-0
14. Dolan RD, Baker J, Harer K, et al. Small Intestinal Bacterial Overgrowth: Clinical Presentation in Patients with Roux-en-Y Gastric Bypass. Obes Surg. 2021;31(2):564-9. DOI:10.1007/s11695-020-05032-y
15. Kaniel O, Sherf-Dagan S, Szold A, et al. The Effects of One Anastomosis Gastric Bypass Surgery on the Gastrointestinal Tract. Nutrients. 2022;14(2):304. DOI:10.3390/nu14020304
16. Lakhani SV, Shah HN, Alexander K, et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res. 2008;28(5):293-8. DOI:10.1016/j.nutres.2008.03.002
17. Lauritano EC, Gabrielli M, Scarpellini E, et al. Antibiotic therapy in small intestinal bacterial overgrowth: rifaximin versus metronidazole. Eur Rev Med Pharmacol Sci. 2009;13(2):111-6.
18. Vujasinovic M, Valente R, Thorell A, et al. Pancreatic Exocrine Insufficiency after Bariatric Surgery. Nutrients. 2017;9(11):1241. DOI:10.3390/nu9111241
19. Brunet E, Caixàs A, Puig V. Review of the management of diarrhea syndrome after a bariatric surgery. Endocrinol Diabetes Nutr (Engl Ed). 2020;67(6):401-7. DOI:10.1016/j.endinu.2019.09.013
20. Ozmen MM, Gundogdu E, Guldogan CE, Ozmen F. The Effect of Bariatric Surgery on Exocrine Pancreatic Function. Obes Surg. 2021;31(2):580-7. DOI:10.1007/s11695-020-04950-1
21. Chaudhary A, Domínguez-Muñoz JE, Layer P, Lerch MM. Pancreatic Exocrine Insufficiency as a Complication of Gastrointestinal Surgery and the Impact of Pancreatic Enzyme Replacement Therapy. Dig Dis. 2020;38(1):53-68. DOI:10.1159/000501675
22. Scarpellini E, Arts J, Karamanolis G, et al. International consensus on the diagnosis and management of dumping syndrome. Nat Rev Endocrinol. 2020;16(8):448-66. DOI:10.1038/s41574-020-0357-5
23. Moreira RO, Moreira RB, Machado NA, et al. Postp-randial hypoglycemia after bariatric surgery pharmacological treatment with verapamil and acarbose. Obes Surg. 2008;18(12):1618-21. DOI:10.1007/s11695-008-9569-9
24. Mundi MS, Vallumsetla N, Davidson JB, et al. Use of home parenteral nutrition in post-bariatric surgery-related malnutrition. JPEN J Parenter Enteral Nutr. 2017;41(7):1119-24. DOI:10.1177/0148607116649222
25. Jeppesen PB, Gabe SM, Seidner DL, et al. Factors Associated With Response to Teduglutide in Patients With Short-Bowel Syndrome and Intestinal Failure. Gastroenterology. 2018;154(4):874-85. DOI:10.1053/j.gastro.2017.11.023
26. Afshar S, Kelly SB, Seymour K, et al. The Effects of Bariatric Procedures on Bowel Habit. Obes Surg. 2016;26(10):2348-54. DOI:10.1007/s11695-016-2100-9
27. Scientific Advisory Committee on Nutrition. Carbohydrates and Health Report. 2015. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/4455... Accessed: 13.06.2022.
28. Ivezaj V, Benoit SC, Davis J, et al. Changes in Alcohol Use after Metabolic and Bariatric Surgery: Predictors and Mechanisms. Curr Psychiatry Rep. 2019;21(9):85. DOI:10.1007/s11920-019-1070-8
29. Ibrahim N, Alameddine M, Brennan J, et al. New onset alcohol use disorder following bariatric surgery. Surg Endosc. 2019;33(8):2521-30. DOI:10.1007/s00464-018-6545-x
30. Mellinger JL, Shedden K, Winder GS, et al. Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse. Liver Int. 2021;41(5):1012-19. DOI:10.1111/liv.14805
31. Acevedo MB, Eagon JC, Bartholow BD, et al. Sleeve gastrectomy surgery: when 2 alcoholic drinks are converted to 4. Surg Obes Relat Dis. 2018;14(3):277-83. DOI:10.1016/j.soard.2017.11.010
32. Acevedo MB, Teran-Garcia M, Bucholz KK, et al. Alcohol sensitivity in women after undergoing bariatric surgery: a cross-sectional study. Surg Obes Relat Dis. 2020;16(4):536-44. DOI:10.1016/j.soard.2020.01.014
33. Yska JP, Gertsen S, Flapper G, et al. NSAID Use after Bariatric Surgery: a Randomized Controlled Intervention Study. Obes Surg. 2016;26(12):2880-5. DOI:10.1007/s11695-016-2218-9
34. Begian A, Samaan JS, Hawley L, et al. The use of nonsteroidal anti-inflammatory drugs after sleeve gastrectomy. Surg Obes Relat Dis. 2021;17(3):484-8. DOI:10.1016/j.soard.2020.11.016

Авторы

Т.А. Ильчишина*1, Ю.А. Кучерявый2, Т.Н. Свиридова3,4

1 ООО «СМ-Клиника», Санкт-Петербург, Россия;
2 АО «Ильинская больница», Глухово, Россия;
3 ФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава России, Воронеж, Россия;
4 OOO «Клиника “Город Здоровья”», Воронеж, Россия
*ita17@mail.ru

________________________________________________

Tatiana A. Ilchishina*1, Yury A. Kucheryavyy2, Tatiana N. Sviridova3,4

1 SM-Clinic, Saint Petersburg, Russia;
2 Ilyinskaya Hospital, Glukhovo, Russia;
3 Burdenko Voronezh State Medical University, Voronezh, Russia;
4 Clinic “City of Health”, Voronezh, Russia
*ita17@mail.ru

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