Evidence map›Paper›PMID 39920373›Full record

SynthesisSurgical endoscopy2025

Bariatric surgery and relevant comorbidities: a systematic review and meta-analysis.

Claire Wunker, Sunjay Kumar, Peter Hallowell, Amelia Collings, Lindsey Loss, Varun Bansal, Bradley Kushner, Theofano Zoumpou, Tammy Lyn Kindel, D Wayne Overby and 11 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Claire Wunker *Department of Surgery, Saint Louis University, St. Louis, USA.
Sunjay Kumar *Department of Surgery, Jefferson University, Philadelphia, USA.
Peter HallowellDepartment of Surgery, University of Virginia, Charlottesville, USA.
Amelia CollingsDepartment of Surgery, University of Louisville, Louisville, USA.
Lindsey LossDepartment of Surgery, Oregon Health and Science University, Portland, USA.
Varun BansalDepartment of Surgery, University of Colorado, Boulder, USA.
Bradley KushnerDepartment of Surgery, Washington University in St. Louis, St. Louis, USA.
Theofano ZoumpouDepartment of Surgery, Rutgers New Jersey Medical School, Newark, USA.
Tammy Lyn KindelDepartment of Surgery, Medical College of Wisconsin, Milwaukee, USA.
D Wayne OverbyDepartment of Surgery, University of North Carolina, Chapel Hill, USA.
Julietta ChangDepartment of Surgery, Kaiser Permanente Bellevue Medical Center, Bellevue, USA.
Subhashini AylooDepartment of Surgery, Brown University, Providence, USA.
Andrew F SabourDepartment of Surgery, University of Nevada, Reno, USA.
Omar M GhanemDepartment of Surgery, Mayo Clinic, Arizona, USA.
Essa AleassaDepartment of Surgery, Cleveland Clinic, Cleveland, USA.
Adam ReidDepartment of Surgery, Southern Illinois University School of Medicine, Springfield, USA.
Noe RodriguezDepartment of Surgery, Cleveland Clinic, Cleveland, USA.
Ivy N HaskinsDepartment of Surgery, University of Nebraska Medical Center, Omaha, USA.
L Renee HiltonDepartment of Surgery, Medical College of Georgia, Augusta, USA.
Bethany J SlaterDepartment of Surgery, University of Chicago, Chicago, USA.
Francesco PalazzoDepartment of Surgery, Medical Office Building, Thomas Jefferson University Hospital, 1100 Walnut Street, 5 Floor, Philadelphia, PA, 19107, USA. francesco.palazzo@jefferson.edu.ORCID 0000-0002-5614-0884

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is a growing epidemic in the United States, and with this, has come an increasing volume of metabolic surgery operations. The ideal management of obesity-associated medical conditions surrounding these operations is yet to be determined. This review sought to investigate the routine use of intraoperative cholangiogram (IOC) with cholecystectomy during or after a bypass-type operation, the ideal management of post-sleeve gastrectomy gastroesophageal reflux disease (GERD), and the optimal bariatric operation in patients with known inflammatory bowel disease (IBD).

methodsUsing medical literature databases, searches were performed for randomized controlled trials (RCTs) and non-randomized comparative studies from 1990 to 2022. Each study was screened by two independent reviewers from the SAGES Guidelines Committee for eligibility. Data were extracted while assessing the risk of bias using the Cochrane Risk of Bias 2.0 Tool and the Newcastle-Ottawa Scale for RCTs and cohort studies, respectively. A meta-analysis was performed using random effects.

resultsRoutine use of IOC was associated with a significantly decreased rate of common bile duct injury and a trend towards decreased intraoperative complications, perioperative complications, and mortality. The rates of reoperation, postoperative pancreatitis, cholangitis, and choledocholithiasis were low in the routine use of the IOC group, but no non-routine use studies evaluated these outcomes. After sleeve gastrectomy, GERD-specific quality of life was significantly higher in the surgically treated group compared to the medically treated group. Bypass-type operations had worse outcomes of IBD sequelae than sleeve gastrectomy, including pain, patient perception, and fistula formation. Sleeve patients had lower mortality and fewer short- and long-term complications.

conclusionsLow-quality data limited the conclusions that were drawn; however, trends were observed favoring the routine use of IOC during cholecystectomy for patients with bypass-type anatomy, surgical treatment of GERD post-sleeve gastrectomy, and sleeve gastrectomy in IBD patients. Future research proposals are suggested to further answer the questions posed.

Indexed as

Bariatric SurgeryCholangiographyGastroesophageal RefluxInflammatory Bowel DiseasesObesity, MorbidCholecystectomyComorbidityGastrectomyHumansIntraoperative CarePostoperative ComplicationsBariatricCholangiogramComorbiditiesGERDIBDMetabolic surgery

Identifiers

PMID39920373
PMCPMC11870965

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.