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lüll Bariatric surgery Runkel N; Colombo-Benkmann M; Huttl TP; Tigges H; Mann O; Sauerland SDtsch Arztebl Int 2011[May]; 108 (20): 341-6BACKGROUND: Bariatric surgery has increased in numbers, but the treatment of morbid obesity in Germany still needs improvement. The new interdisciplinary S3-guideline provides information on the appropriate indications, procedures, techniques, and follow-up care. METHODS: Systematic review of the literature, classification of the evidence, graded recommendations, and interdisciplinary consensus-building. RESULTS: Bariatric surgery is a component of the multimodal treatment of obesity, which consists of multidisciplinary evaluation and diagnosis, conservative and surgical treatments, and lifelong follow-up care. The current guideline extends the BMI-based spectrum of indications that was previously proposed (BMI greater than 40 kg/m(2), or greater than 35 kg/m(2)with secondary diseases) by eliminating age limits, as well as most of the contraindications. A prerequisite for surgery is that a structured, conservative weight-loss program has failed or is considered to be futile. Type 2 diabetes is now considered an independent indication under clinical study conditions for patients whose BMI is less than 35 kg/m(2) (metabolic surgery). The standard laparoscopic techniques are gastric banding, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion. The choice of procedure is based on knowledge of the results, long-term effects, complications, and individual circumstances. Structured lifelong follow-up should be provided and should, in particular, prevent metabolic deficiencies. CONCLUSION: The guideline contains recommendations based on the scientific evidence and on a consensus of experts from multiple disciplines about the indications for bariatric surgery, the choice of procedure, techniques, and follow-up care. It should be broadly implemented to improve patient care in this field.|Bariatric Surgery/*adverse effects/*methods[MESH]|Foreign-Body Migration/diagnostic imaging/*etiology[MESH]|Hernia, Abdominal/diagnostic imaging/*etiology[MESH]|Humans[MESH]|Malabsorption Syndromes/diagnostic imaging/*etiology[MESH]|Obesity, Morbid/*surgery[MESH]|Radiography[MESH] |