Tarasiuk T. Substantiation of indications and choice of method of' surgical treatment of patients with alimentary-constitutional obesity

The results of surgical treatment of 105 patients with alimentary-constitutional obesity have been studied. The methods of surgical treatment of obesity have been analysed. The criteria for selection of patients for surgical treatment of obesity were determined. The indications and contraindications for intragastric balloon useing, regulated gastric banding, gastric sleeve resection, gastric bypass, biliopancreatic diversion with duodenal switch were defined. The possible complications after each bariatric intervention have been studied. The algorithm of surgical treatment of obesity based on body mass index, disturbance of carbohydrate and lipid metabolism was developed. The use of intragastric balloon is indicated for patients with body mass index 25 - 39 kg/m2 and patients with morbid obesity as the first stage of treatment to reduce the risk of further surgery, to create a stereotype of food. The priority in treatment of patients with morbid obesity is the use of restrictive operations (regulated gastric banding and gastric sleeve resection). The combined bariatric operations should perform to patients with morbid obesity and disorders of carbohydrate metabolism, and also to patients with superobesity. Conducting purposeful prophylaxis and development the algorithm of diagnostic and treatment allowed to avoid general surgical and significantly reduce the frequency of specific complications to 3.2% after useing intragastric balloon, to 5.4% - after bariatric operations.