nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-198-2-86-102nogr-1872Research ArticleХИРУРГИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯSURGICAL GASTROENTEROLOGYМетаболическая хирургия: от истории к реальным достижениямMetabolic surgery: from history to real achievementshttps://orcid.org/0000-0001-5129-9944ГалагудзаМ. М.GalagudzaM. M.galagoudza@mail.ruНеймаркА. Е.NeimarkA. E.noemail@neicon.ruКорнюшинО. В.KornyushinO. V.noemail@neicon.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова» Министерства здравоохранения Российской Федерации; Национальный медицинский исследовательский центр имени В. А. АлмазоваРоссияPavlov First Saint Petersburg State Medical University; Almazov National Medical Research CentreRussian FederationНациональный медицинский исследовательский центр имени В. А. АлмазоваРоссияAlmazov National Medical Research CentreRussian Federation2022050420220286102Copyright © Галагудза М.М., Неймарк А.Е., Корнюшин О.В., 20222022Галагудза М.М., Неймарк А.Е., Корнюшин О.В.Galagudza M.M., Neimark A.E., Kornyushin O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1872

Бариатрическая и метаболическая хирургия зародилась в середине XX века и выросла из экспериментальных хирургических методов направленных на снижение веса. В процессе исследования и совершенствования хирургических методик происходило выделение более физиологичных операций, характеризующихся меньшим количеством осложнений, формировались концепции хирургического лечения атерогенных дислипидемий и предупреждения развития атеросклероза, снижения риска развития метаболических или сердечно-сосудистых осложнений тяжелого ожирения, представления о метаболической операции как о средстве для достижения гликемического контроля. В статье приведена актуальная информация о современных метаболических операциях, таких как бандажирование желудка, продольная резекция желудка, желудочное шунтирование или гастрошунтирование по Ру (Roux-en-Y gastricbypass), билиопанкреатическое шунтирование. Представлены данные об эффективности метаболических операций в лечении ожирения и сахарного диабета 2 типа за счет создания механического ограничения для поступления пищи в верхние отделы желудочно-кишечного тракта, уменьшения чувства голода за счет снижения уровня гормона грелина, уменьшения количества висцерального жира, формирования синдрома мальабсорбции, инкретиновый эффект, гипотезы передней (Foregut) и задней (Hindgut) кишки. Также обсуждается влияние бариатрических операций на сердечно-сосудистую систему и неалкогольную жировую болезнь печени.

Bariatric and metabolic surgery began in the mid-20th century and grew out of experimental surgical techniques for weight loss. In the process of research and improvement of surgical techniques, more physiological operations were identified, characterized by fewer complications, concepts of surgical treatment of atherogenic dyslipidemias and prevention of atherosclerosis development, reduction of the risk of metabolic or cardiovascular complications of severe obesity, the idea of metabolic surgery to achieve glycemic control. The article provides up-to-date information on modern metabolic operations, such as gastric banding, longitudinal gastric resection, gastric bypass or Roux-en-Y gastric bypass, biliopancreatic bypass. The paper presents data on the effectiveness of metabolic operations in the treatment of obesity and type 2 diabetes mellitus by creating a mechanical restriction for food intake in the upper gastrointestinal tract, reducing hunger by reducing the level of the hormone ghrelin, reducing the amount of visceral fat, the formation of malabsorption syndrome, incretin effect, hypotheses of the anterior (Foregut) and posterior (Hindgut) gut. It also discusses the effects of bariatric surgery on the cardiovascular system and non-alcoholic fatty liver disease.

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The authors declare that there are no conflicts of interest present.