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Practice Guideline
. 2025 Sep;77(5):1603-1625.
doi: 10.1007/s13304-024-01996-z. Epub 2024 Oct 17.

SICOB Italian clinical practice guidelines for the surgical treatment of obesity and associated diseases using GRADE methodology on bariatric and metabolic surgery

Maurizio De Luca  1 , Monica Zese  2 , Giulia Bandini  3 , Marco Antonio Zappa  4 , Ugo Bardi  5 , Maria Grazia Carbonelli  6 , Francesco Maria Carrano  7 , Giovanni Casella  8 , Marco Chianelli  9 , Sonja Chiappetta  10 , Angelo Iossa  11 , Alessandro Martinino  12 , Fausta Micanti  13 , Giuseppe Navarra  14 , Giacomo Piatto  15 , Marco Raffaelli  16 , Eugenia Romano  17 , Simone Rugolotto  1 , Roberto Serra  18 , Emanuele Soricelli  19 , Antonio Vitiello  13 , Luigi Schiavo  20 , Iris Caterina Maria Zani  21   22 , Benedetta Ragghianti  3 , Valentina Lorenzoni  23 , Gerardo Medea  24 , Valentina Antognozzi  25 , Rosario Bellini  26 , Giovanna Berardi  13 , Fabio Cesare Campanile  27 , Enrico Facchiano  28 , Mirto Foletto  29 , Paolo Gentileschi  30 , Stefano Olmi  31 , Massimiliano Petrelli  32 , Vincenzo Pilone  33 , Giuliano Sarro  34 , Donatella Ballardini  35 , Dario Bettini  36 , Andrea Costanzi  37 , Francesco Frattini  38 , Giovanni Lezoche  39 , Barbara Neri  40 , Debora Porri  41 , Andrea Rizzi  38 , Roberto Rossini  42 , Luca Sessa  16 , Rossella D'Alessio  43 , Gianluca Di Mauro  44 , Salvatore Tolone  45 , Paolo Bernante  46 , Ludovico Docimo  45 , Diego Foschi  47 , Luigi Angrisani  48 , Nicola Basso  49 , Luca Busetto  29 , Nicola Di Lorenzo  7 , Olga Disoteo  50 , Pietro Forestieri  13 , Mario Musella  13 , Barbara Paolini  51 , Gianfranco Silecchia  52 , Matteo Monami  3
Affiliations
Practice Guideline

SICOB Italian clinical practice guidelines for the surgical treatment of obesity and associated diseases using GRADE methodology on bariatric and metabolic surgery

Maurizio De Luca et al. Updates Surg. 2025 Sep.

Abstract

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m2), metabolic bariatric surgery can be a valid therapeutic option. Many different types of surgical procedures have been developed in last decades, mainly performed via laparoscopic approaches. However, clinical indications for metabolic and bariatric surgery (MBS) and the choice of the most appropriate type of procedure have not been clarified so far.The Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to design and develop the updated version of the Italian guidelines aimed at assisting healthcare professionals in the choice of the surgical option for the treatment of obesity and related conditions. Between June and October 2022, a panel of 24 experts and an evidence review team (ERT, 10 members), participated in the definition of clinical questions, outcomes, and recommendations and collected and analyzed all the available evidence on the basis of pre-specified search strategies. GRADE methodology and PICO (Patient, Intervention, Comparison, Outcome) conceptual framework have been adopted for the development of the present guidelines. Aim of the present guideline is to verify indications to surgery with respect to the presence of comorbid conditions, evaluate the different types of surgical approaches and endoscopic bariatric procedure and revise indication to revision surgery and postoperative procedures.

Keywords: Bariatric surgery; Guidelines; Obesity.

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Conflict of interest statement

Declarations. Ethical Standards, Disclosure of potential conflicts of interest, Research involving human participants and/or animals, and Informed consent: Not applicable.

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