DOI: 10.1111/cob.12722 ISSN: 1758-8103

An international Delphi consensus on patient preparation for metabolic and bariatric surgery

Danielle R. Clyde, Reza Adib, Sarfaraz Baig, Aparna G. Bhasker, James Byrne, David Cameron, Copaescu Catalain, Ken Clare, Andrew de Beaux, Gillian Drummond, Hayssam Fawal, Martin Fried, Omar Ghanem, Yitka Graham, Ramen Goel, George Hopkins, Farah Husain, Brian Joyce, Mohammad Kermansaravi, Shanu Kothari, Lilian Kow, Silvia Leite, Brij Madhok, David Mahon, Karl Miller, Alex Miras, Osama Moussa, Manoel G. Neto, Abdelrahman Nimeri, Mary O'Kane, Chetan Parmar, Ralph Peterli, Luis Poggi, Paulina Saliminen, Rupa Sarkar, Jon Shenfine, Stephanie Sogg, Erik Stenberg, Michel Suter, Safwan Taha, Abd Tahrani, Ramon Vilallonga, Kelvin Voon, Richard Welbourn, Carlos Zerrweck, Peter Lamb, Kamal K. Mahawar, Wah Yang, Andrew G. N. Robertson

Summary

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m2), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources. Updated in 2022, ASMBS and IFSO guidelines aim to standardise MBS indications, reflecting current understanding and emphasising comprehensive preoperative assessments. Yet, clinical variability persists, necessitating consensus‐based recommendations. This modified Delphi study engaged 45 global experts to establish consensus on perioperative management in MBS. Experts selected from bariatric societies possessed expertise in MBS and participated in a two‐round Delphi protocol. Consensus was achieved on 90 of 169 statements (53.3%), encompassing multidisciplinary team composition, patient selection criteria, preoperative testing, and referral pathways. The agreement highlighted the critical role of comprehensive preoperative assessments and the integration of healthcare professionals in MBS. These findings offer essential insights to standardise perioperative practices and advocate for evidence‐based guidelines in MBS globally. The study underscores the need for unified protocols to optimise outcomes and guide future research in MBS.

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