De la chirurgie bariatrique à la chirurgie métabolique : une histoire en devenir Partie 2. L'histoire de la chirurgie métabolique

Metabolic surgery is an operative manipulation ofa normal organ to achieve a healthy biological result. The first step of metabolic surgery was represented by partial ileal bypass which was the intervention modality for the first affirmative lipid atheroscle-rosis trial. However the marked lowering LDL-cholesterol induced by this procedure was not clinically pertinent after the arrival of statins. Now metabolic surgery is under question in the field of type 2 diabetes (T2D). Precocious diabetes remissions were frequently reported after bariatric surgery especially gastric bypass. The fact that glucose homeostasis was achieved with a weight-loss independent mechanism has led to the paradigm that T2D may be a surgical disease. The reasons of this dramatically improvement in diabetes after surgery are now under evaluation.