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Background: Bariatric surgery is a widely accepted treatment for morbid obesity, yet there is ongoing debate regarding the efficacy and safety of various surgical procedures. This systematic review aims to evaluate and compare the effectiveness of different bariatric surgery techniques to provide evidence-based clinical guidelines. Methods: A systematic search of PubMed, Cochrane Library, and Embase databases was conducted. Studies were selected based on predefined inclusion criteria, focusing on randomized controlled trials (RCTs), cohort studies, and case-control comparisons of different bariatric surgical techniques, including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), adjustable gastric banding (AGB), and biliopancreatic diversion with duodenal switch (BPD/DS). Outcomes measured included weight loss, resolution of comorbidities, postoperative complications, and quality of life. Results: A total of number studies involving number of patients were included. RYGB and SG were found to produce the most significant weight loss and resolution of obesity-related comorbidities compared to AGB. However, RYGB was associated with significantly more nutrient deficiencies than SG, while long-term complications were less frequent among SG patients. BPD/DS resulted in substantial weight loss but also had elevated rates of severe complications. Quality of life improvements were generally high across all procedures, though some differences were noted between the techniques. Conclusion: This systematic review highlights the advantages and disadvantages of each bariatric surgery technique. While all procedures result in significant weight loss and improvement in comorbidities, the complication profiles and nutritional consequences vary, particularly between RYGB and SG. BPD/DS offers the most substantial weight loss but carries higher risks. These findings support the development of personalized treatment models based on individual patient characteristics, comorbidity profiles, and risk tolerance. Further high-quality studies are necessary to confirm these findings and refine clinical practice guidelines.
Praveenkumar Periyasamy (Wed,) studied this question.