Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

Sauerland, S.; Angrisani, L.; Belachew, M.; Chevallier, J. M.; Favretti, F.; Finer, N.; Fingerhut, A.; Garcia Caballero, M.; Guisado Macias, J. A.; Mittermair, R.; Morino, M.; Msika, S.; Rubino, F.; Tacchino, R.; Weiner, R.; Neugebauer, E. A. M.

doi:10.1007/s00464-004-9194-1

Cited by 420Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

Sauerland, S., Angrisani, L., Belachew, M., Chevallier, J. M., Favretti, F., Finer, N., Fingerhut, A., Garcia Caballero, M. +8 more·2005·Surgical Endoscopy

DOI 10.1007/s00464-004-9194-1

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Abstract

Background The increasing prevalence of morbid obesity together with the development of laparoscopic approaches has led to a steep rise in the number of bariatric operations. These guidelines intend to define the comparative effectiveness and surrounding circumstances of the various types of obesity surgery.Methods A consensus panel representing the fields of general/endoscopic surgery, nutrition and epidemiology convened to agree on specific questions in obesity surgery. Databases were systematically searched for clinical trial results in order to produce evidence-based recommendations. Following two days of discussion by the experts and a plenary discussion, the final statements were issued.Recommendations After the patient's multidisciplinary evaluation, obesity surgery should be considered in adults with a documented BMI greater than or equal to 35 and related comorbidity, or a BMI of at least 40. In addition to standard laboratory testing, chest radiography, electrocardiography, spirometry, and abdominal ultrasonography, the preoperative evaluation of obesity surgery patients also includes upper gastrointestinal endoscopy or radiologic evaluation with a barium meal. Psychiatric consultation and polysomnography can safely be restricted to patients with clinical symptoms on preoperative screening. Adjustable gastric banding (GB), vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure therefore should be tailored to the individual situation. There is evidence that a laparoscopic approach is advantageous for LAGB, VBG, and GB (and probably also for BPD). Antibiotic and antithromboembolic prophylaxis should be used routinely. Patients should be seen 3 to 8 times during the first postoperative year, 1 to 4 times during the second year and once or twice a year thereafter. Outcome assessment after surgery should include weight loss and maintainance, nutritional status, comorbidities and quality-of-life.

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Screening using the STOP-BANG criteria seemed to be predictive of postoperative complications in several observational studies.
“Nevertheless, screening using the STOP-BANG criteria seemed to be predictive of postoperative complications in several observational studies [3, 4, 8, 9, 47, 48, 52, 53].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [4]

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Laparoscopic Adjustable Gastric Banding: Lessons from the First 500 Patients in a Single Institution
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Is Routine Cholecystectomy Required During Laparoscopic Gastric Bypass?
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A Bariatric Surgery Algorithm
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Patient management after LAP-BAND placement
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Stenosis of the Gastroenterostomy after Laparoscopic Gastric Bypass
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Results of Bariatric Surgery for Morbid Obesity in Patients Older than 50 Years
Murr, M. M., Siadati, M. R., & Sarr, M. G. (1995) · Obesity Surgery · doi:10.1381/096089295765557494 · Cited by 89 · see citing works
Incidence of clinically evident deep venous thrombosis after Laroscopic Roux-en-Y Gastric bypass
González, Q. H., Tishler, D. S., Plata-Muñoz, J. J., et al. (2004) · Surgical Endoscopy · doi:10.1007/s00464-003-8202-1 · Cited by 89 · see citing works
BAROS: An Effective System to Evaluate the Results of Patients after Bariatric Surgery
Wolf, A. M., Falcone, A., Kortner, B., et al. (2000) · Obesity Surgery · doi:10.1381/096089200321593940 · Cited by 89 · see citing works
Pouch Dilatation and Slippage after Adjustable Gastric Banding: Is it Still an Issue?
Dargent, J. (2003) · Obesity Surgery · doi:10.1381/096089203321136692 · Cited by 88 · see citing works
A 15-Year Evaluation of Biliopancreatic Diversion According to the Bariatric Analysis Reporting Outcome System (BAROS)
Marinari, G. M., Murelli, F., Camerini, G. B., Papadia, F. S., Carlini, F., Stabilini, C., Adami, G., & Scopinaro, N. (2004) · Obesity Surgery · doi:10.1381/096089204322917828 · Cited by 88 · see citing works
Laparoscopic Roux-en-Y Gastric Bypass – Evaluation of Three Different Techniques
Abdel-Galil, E., & Sabry, A. A. (2002) · Obesity Surgery · doi:10.1381/096089202321019602 · Cited by 87 · see citing works
Esophageal Anatomy and Function in Laparoscopic Gastric Restrictive Bariatric Surgery: Implications for Patient Selection
Greenstein, R. J., Nissan, A., & Jaffin, B. W. (1998) · Obesity Surgery · doi:10.1381/096089298765554818 · Cited by 87 · see citing works
Obesity morbidity and health care costs in France: an analysis of the 1991–1992 Medical Care Household Survey
Detournay, B., Fagnani, F., Phillippo, M., et al. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801099 · Cited by 87 · see citing works
Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-band system implantation
Iovino, P., Angrisani, L., Tremolaterra, F., et al. (2002) · Surgical Endoscopy · doi:10.1007/s00464-001-9225-0 · Cited by 87 · see citing works
Self-citation
Incidence of Deep Venous Thrombosis in Patients Undergoing Obesity Surgery
Westling, A., Bergqvist, D., Boström, A., Karacagil, S., & Gustavsson, S. (2002) · World Journal of Surgery · doi:10.1007/s00268-001-0251-9 · Cited by 87 · see citing works
The Boston Interview for Gastric Bypass: Determining the Psychological Suitability of Surgical Candidates
Sogg, S., & Mori, D. L. (2004) · Obesity Surgery · doi:10.1381/096089204322917909 · Cited by 86 · see citing works
Open Versus Laparoscopic Adjustable Silicone Gastric Banding
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Intragastric balloon in the treatment of patients with morbid obesity
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A Comparison of Diet and Exercise Therapy Versus Laparoscopic Roux-En-Y Gastric Bypass Surgery for Morbid Obesity: A Decision Analysis Model
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Laparoscopic Adjustable Silicone Gastric Banding Versus Vertical Banded Gastroplasty in Morbidly Obese Patients
Morino, M., Toppino, M., Bonnet, G., & GENIO, G. D. (2003) · Annals of Surgery · doi:10.1097/01.sla.0000098627.18574.72 · Cited by 82 · see citing works
Self-citation
Long-term (5-year) results after either horizontal gastroplasty or very-low-calorie diet for morbid obesity.
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Three Years Experience with the New Intragastric Balloon, and A Preoperative Test for Success witb Restrictive Surgery
Loffredo, A., Cappuccio, M., Luca, M. D., Werra, C. D., Galloro, G., Naddeo, M., & Forestieri, P. (2001) · Obesity Surgery · doi:10.1381/096089201321336700 · Cited by 81 · see citing works

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European Guidelines for Obesity Management in Adults
Yumuk, V., Tsigos, C., Fried, M., Schindler, K., Busetto, L., Micic, D., & Toplak, H. (2015) · Obesity Facts · doi:10.1159/000442721 · Cited by 3,432 · see citing works
Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP
Di Lorenzo, N., Antoniou, S. A., Batterham, R. L., Busetto, L., Godoroja, D., Iossa, A., Carrano, F. M., Agresta, F., Alarçon, I., Azran, C., et al. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-07555-y · Cited by 465 · see citing works
Recommendations for the Presurgical Psychosocial Evaluation of Bariatric Surgery Patients
Sogg, S., Lauretti, J., & West-Smith, L. (2016) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2016.02.008 · Cited by 310 · see citing works
Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)
De Luca, M., Angrisani, L., Himpens, J., Busetto, L., Scopinaro, N., Weiner, R., Sartori, A., Stier, C., Lakdawala, M., Bhasker, A. G., et al. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2271-4 · Cited by 296 · see citing works
Self-citation
Post‐operative behavioural management in bariatric surgery: a systematic review and meta‐analysis of randomized controlled trials
Rudolph, A., & Hilbert, A. (2013) · Obesity Reviews · doi:10.1111/obr.12013 · Cited by 173 · see citing works
The role of routine preoperative upper endoscopy in bariatric surgery: a systematic review and meta-analysis
Bennett, S., Gostimir, M., Shorr, R., Mallick, R., Mamazza, J., & Neville, A. (2016) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2016.04.012 · Cited by 111 · see citing works
Preoperative Endoscopy Prior to Bariatric Surgery: a Systematic Review and Meta-Analysis of the Literature
Parikh, M., Liu, J., Vieira, D., Tzimas, D., Horwitz, D., Antony, A., Saunders, J. K., Ude-Welcome, A., & Goodman, A. (2016) · Obesity Surgery · doi:10.1007/s11695-016-2232-y · Cited by 85 · see citing works
The Effect of Helicobacter pylori on Postoperative Outcomes in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis
Mocanu, V., Dang, J. T., Switzer, N., Skubleny, D., Shi, X., de Gara, C., Birch, D. W., & Karmali, S. (2018) · Obesity Surgery · doi:10.1007/s11695-017-3024-8 · Cited by 44 · see citing works
How Effective Is the Multidisciplinary Team Approach in Bariatric Surgery?
Bullen, N. L., Parmar, J., Gilbert, J., Clarke, M., Cota, A., & Finlay, I. G. (2019) · Obesity Surgery · doi:10.1007/s11695-019-03975-5 · Cited by 39 · see citing works

Authors: Sauerland, S., Angrisani, L., Belachew, M., Chevallier, J. M., Favretti, F., Finer, N., Fingerhut, A., Garcia Caballero, M., Guisado Macias, J. A., Mittermair, R., Morino, M., Msika, S., Rubino, F., Tacchino, R., Weiner, R., & Neugebauer, E. A. M.
Affiliations: European Association for Endoscopic Surgery (NL)
Federico II University Hospital (IT)
Centre Hospitalier Régional de Huy (BE)
Hôpital Européen Georges-Pompidou (FR)
University of Padua (IT)
Addenbrooke's Hospital (GB)
Centre Hospitalier Intercommunal de Poissy (FR)
Innsbruck Medical University (AT)
University of Turin (IT)
Hôpital Louis-Mourier (FR)
Hôpitaux Universitaires de Strasbourg (FR)
Krankenhaus Sachsenhausen (DE)
University of Cologne (DE)
Corresponding author: Neugebauer, E. A. M.
ORCID: Sauerland, S.
Angrisani, L.
Chevallier, J. M.
Finer, N.
Fingerhut, A.
Morino, M.
Rubino, F.
Venue: Surgical Endoscopy
Publisher: Springer Science and Business Media LLC
Published: 2004-12-02
Volume: 19
Issue: 2
Pages: 200-221
ISSN: 0930-2794 (ISSN-L)
1432-2218
DOI: 10.1007/s00464-004-9194-1
OpenAlex: W1977738151
Cited by: 420
References: 377
Citations by year: 2026: 4 · 2025: 8 · 2024: 10 · 2023: 3 · 2022: 15 · 2021: 17 · 2020: 27 · 2019: 28 · 2018: 21 · 2017: 18 · 2016: 17 · 2015: 24 · 2014: 29 · 2013: 29 · 2012: 19
FWCI: 14.53
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Surgical Endoscopy (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords: bariatric surgery, morbid obesity, laparoscopic adjustable gastric banding, vertical banded gastroplasty, Roux-en-Y gastric bypass, biliopancreatic diversion, preoperative assessment, postoperative follow-up, weight loss, weight maintenance, surgical complications, antibiotic prophylaxis, quality of life, comorbidities
MeSH terms: Adolescent, Adult, Clinical Competence, Europe, Female, Humans, Length of Stay, Male, Obesity, Morbid, Patient Care Team, Laparoscopy, Postoperative Care, Quality of Life, Gastric Bypass, Gastroplasty, Biliopancreatic Diversion, Body Mass Index, Endoscopy, Gastrointestinal, Treatment Outcome, Nutritional Support, Bariatric Surgery

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Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

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