Резюме. Обследовано 70 пациентов с ожирением и сахарным диабетом 2 типа до и на протяжении 5 лет после билиопанкреатического шунтирования: через 3 месяца после операции у больных отмечено существенное улучшение состояния углеводного и липидного обмена, которое наряду со сниженной массой тела сохранялось на протяжении всего срока наблюдения. Status of carbohydrate and lipid metabolism in obese patients with type 2 diabetes mellitus after biliopancreatic diversion surgery ErshovaAbstract. We examined 70 patients with obesity and diabetes mellitus type 2 before and within 5 years after BPD: these patients showed a significant improvement in the status of carbohydrate and lipid metabolism within 3 months after surgery. This improvement has remained stable along with the reduced body weight during the whole observation period of up to 5 years.

Searching the optimal options for reoperations in overweight patients has the same lengthy and difficult history as all bariatric surgery. The key issues of this aspect of obesity surgery are inefficiency (inadequate weight reduction or it regain) and the unavoidable complications of conservative methods and the negative effects of primary surgery. Weight regain after bariatric surgery is a multicomponent problem. The main reason for the unsatisfactory results of surgical (and conservative) treatment of obesity in some patients is the nature of obesity – the lifelong chronic recurrent disease. A certain role in the return of excess weight is played by the imperfection of the currently existing surgical procedures for the correction of overweight, as well as the wrong choice of options for surgical interventions and technical errors in their implementation. Increase the number of worldwide operations for obesity and its associated diseases translates the problem of revision bariatric surgery from the category of narrow questions in this field of medicine into a serious problem. The article describes modern approaches to the surgical treatment of re-gaining weight after bariatric operations. It considered options for audit procedures, depending on the previously performed surgery. Original techniques of repeated operations for effective correction of the relapse of overweight are described in article.

Within three years (2011 - 2013), we collected data on the operations carried out by sending a questionnaire to members of the Russian Society of Bariatric Surgeons. In the questionnaire were asked to fill in a table on the total number of operations, their structure, subject to the applicable access and report on fatal cases indicating the cause of death.The number of executed operations (excluding installation gastric balloon) increased from 989 to 1525.In 2012, steel longitudinal gastrectomy performed more often than banding. The share gastroshuntirovany continues to decline throughout the period.In 2013, against the backdrop of a significant increase in the number of bariatric interventions deaths were recorded.