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Gastric bypass surgery refers to a surgical procedure in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass (GBP) procedures. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food. The operation is prescribed to treat morbid obesity (defined as a body mass index greater than 40), type 2 diabetes, hypertension, sleep apnea, and other comorbid conditions. ''Bariatric surgery'' is the term encompassing ''all'' of the surgical treatments for morbid obesity, not just gastric bypasses, which make up only one class of such operations. The resulting weight loss, typically dramatic, markedly reduces comorbidities. The long-term mortality rate of gastric bypass patients has been shown to be reduced by up to 40%. As with all surgery, complications may occur. A study from 2005 to 2006 revealed that 15% of patients experience complications as a result of gastric bypass, and 0.5% of patients died within six months of surgery due to complications. == Uses == Gastric bypass is indicated for the surgical treatment of morbid obesity, a diagnosis which is made when the patient is seriously obese, has been unable to achieve satisfactory and sustained weight loss by dietary efforts, and suffers from comorbid conditions which are either life-threatening or a serious impairment to the quality of life. Prior to 1991, clinicians interpreted serious obesity as weighing at least more than the "ideal body weight", an actuarially-determined body-weight at which one was estimated to be likely to live the longest, as determined by the life-insurance industry. This criterion failed for persons of short stature. In 1991, the National Institutes of Health (NIH) sponsored a consensus panel whose recommendations have set the standard for consideration of surgical treatment, the body mass index (BMI). The BMI is defined as the body weight (in kilograms), divided by the square of the height (in meters). The result is expressed as a number - usually between 15 and 70 - in units of kilograms per square meter. The Consensus Panel of the National Institutes of Health (NIH) recommended the following criteria for consideration of bariatric surgery, including gastric bypass procedures: * people who have a BMI of 40 or higher * people with a BMI of 35 or higher with one or more related comorbid conditions The Consensus Panel also emphasized the necessity of multidisciplinary care of the bariatric surgical patient by a team of physicians and therapists to manage associated comorbidities and nutrition, physical activity, behavior, and psychological needs. The surgical procedure is best regarded as a ''tool'' which enables the patient to alter lifestyle and eating habits, and to achieve effective and permanent management of obesity and eating behavior. Since 1991, major developments in the field of bariatric surgery, particularly laparoscopy, have outdated some of the conclusions of the NIH panel. In 2004 the American Society for Bariatric Surgery (ASBS) sponsored a consensus conference which updated the evidence and the conclusions of the NIH panel. This conference, composed of physicians and scientists of both surgical and non-surgical disciplines, reached several conclusions, including: * bariatric surgery is the most effective treatment for morbid obesity * gastric bypass is one of four types of operations for morbid obesity * laparoscopic surgery is equally effective and as safe as open surgery * patients should undergo comprehensive preoperative evaluation and have multi-disciplinary support for optimum outcome 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Gastric bypass surgery」の詳細全文を読む スポンサード リンク
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