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These recommendations address routine intraoperative cholangiography in patients with bypass-type anatomy, the management of reflux disease after sleeve gastrectomy, and the optimal bariatric procedure for patients with comorbid inflammatory bowel disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A systematic review was conducted including studies published from 1990 to 2022 to address these questions. These results were then presented to a panel of bariatric surgeons who formulated recommendations based on the best available evidence or utilized expert opinion when the evidence base was lacking.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Conditional recommendations were made in favor of routine intraoperative cholangiography in patients with bypass-type anatomy undergoing laparoscopic cholecystectomy, trialing medical management prior to surgical management in patients with reflux after sleeve gastrectomy, and sleeve gastrectomy rather than Roux en Y gastric bypass in patients with inflammatory bowel disease. The strength of these recommendations was limited by the quality of evidence available. Recommendations for future research were made for all questions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>These recommendations should provide guidance regarding management of these comorbidities in patients who are under consideration for or have undergone metabolic and bariatric surgery. These recommendations also identify important areas where the future research should focus to strengthen the evidence base.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-024-11433-2","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T22:45:23Z","timestamp":1733957123000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["SAGES guidelines for the management of comorbidities relevant to metabolic and bariatric surgery"],"prefix":"10.1007","volume":"39","author":[{"given":"Sunjay S.","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Wunker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Collings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofano","family":"Zoumpou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julietta","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noe","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sabour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Renee","family":"Hilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar M.","family":"Ghanem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley S.","family":"Kushner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey Jean","family":"Loss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essa M.","family":"Aleassa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy N.","family":"Haskins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhashini","family":"Ayloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Reid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Wayne","family":"Overby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hallowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy Lyn","family":"Kindel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany J.","family":"Slater","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5614-0884","authenticated-orcid":false,"given":"Francesco","family":"Palazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"11433_CR1","doi-asserted-by":"publisher","first-page":"i2016","DOI":"10.1136\/bmj.i2016","volume":"353","author":"P Alonso-Coello","year":"2016","unstructured":"Alonso-Coello P, Sch\u00fcnemann HJ, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M, Treweek S, Mustafa RA, Rada G, Rosenbaum S, Morelli A, Guyatt GH, Oxman AD, GRADE Working Group (2016) GRADE evidence to decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. 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Aleassa, Ayloo, Bansal, Chang, Collings, Ghanem, Hilton, Kumar, Kushner, Loss, Overby, Palazzo, Reid, Rodriguez, Sabour, Wunker, and Zoumpou report no disclosures. Drs. Hallowell, Haskins, Kindel, and Slater report the following disclosures: Dr. Hallowell\u2014leadership roles within Piedmont Liability Trust (Board of Directors) and Midwest Surgical Association (President-elect). Dr. Haskins\u2014royalties from UpToDate. Dr. Kindel\u2014grants from the National Heart, Lung, and Blood Institute and the American College of Surgeons, consulting fees from Johnson & Johnson, payment or honoraria from the Translational Medicine Academy, travel support from Medtronic and Intuitive, U.S. Provisional Patent Application No. 63\/505,036, and an unpaid leadership role with the Treo Foundation. Dr. Slater\u2014consulting fees from Hologic, leadership role in the SAGES Guidelines committee (Chair).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}