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Gut Failure after Bariatric Surgery: Clinical Types and Surgical Ingenuity 

Gut Failure after Bariatric Surgery: Clinical Types and Surgical Ingenuity
Chapter:
Gut Failure after Bariatric Surgery: Clinical Types and Surgical Ingenuity
Author(s):

Kareem M. Abu-Elmagd

, Ajai Khanna

, Masato Fujiki

, Koji Hashimoto

, Tomasz G. Rogula

, and Guilherme Costa

DOI:
10.1093/med/9780190608347.003.0023
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date: 09 December 2021

The gut plays a central role in the control of whole-body energy equilibrium, with obesity and gut failure being the two extremes of the continuum of disrupted energy homeostasis. In the last 25 years there has been a simultaneous evolution of both bariatric surgery for treatment of morbid obesity and surgical rehabilitation for management of gut failure. This chapter addresses gastrointestinal failure with the need for TPN therapy as a true concern among the bariatric surgery population. A new classification is introduced, along with novel surgical procedures, including visceral transplantation, to restore gut homeostasis and nutritional autonomy. In summary, this chapter features the enigma of patients with gut failure after bariatric surgery and underscores the successful management of these complex patients with the application of surgical ingenuity.

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