Linked to the growing obesity epidemic, demand for bariatric and metabolic surgery has increased, the most common procedures being sleeve gastrectomy and Roux-en-Y gastric bypass. Originally, bariatric procedures were described as purely restrictive, malabsorptive, or combined restrictive–malabsorptive procedures limiting food intake, nutrient absorption, or both. Nowadays, anatomical alterations are known to affect gastrointestinal physiology, which in turn affects the digestion and absorption of nutrients and drugs. Therefore, understanding gastrointestinal physiology is crucial to prevent postoperative nutritional deficiencies and to optimise postoperative drug therapy. Preclinical and clinical research indicates that sleeve gastrectomy accelerates liquid and solid gastric emptying and small intestinal transit, and increases bile acid serum levels, whereas its effects on gastrointestinal acidity, gastric and pancreatic secretions, surface area, and colonic transit remain largely unknown. Roux-en-Y gastric bypass diminishes gastric acid secretion, accelerates liquid gastric emptying, and increases bile acid serum levels, but its effects on intestinal pH, solid gastric emptying, intestinal transit time, gastric enzyme secretions, and surface area remain largely unknown. In this Review, we summarise current knowledge of the effects of these two procedures on gastrointestinal physiology and assess the knowledge gaps.

与肥胖病的流行联系在一起，减肥和代谢手术的需求增加了，最常见的手术是袖胃切除术和Roux-en-Y胃搭桥术。最初，减肥手术被描述为纯粹的限制性饮食，吸收不良或限制饮食摄入，营养吸收或两者兼而有之的限制性饮食不良。如今，已知解剖学改变会影响胃肠道生理，进而影响营养物质和药物的消化吸收。因此，了解胃肠道生理对于预防术后营养缺乏和优化术后药物治疗至关重要。临床前和临床研究表明，套管胃切除术可加速胃液和胃排空以及小肠运输，并增加胆汁酸的血清水平，而其对胃肠道酸度，胃和胰腺分泌物，表面积和结肠转运的影响仍然未知。Roux-en-Y胃旁路减少了胃酸的分泌，加速了胃液的排空，并增加了胆汁酸的血清水平，但其对肠pH值，固体胃排空，肠运输时间，胃酶分泌和表面积的影响仍然未知。在这篇综述中，我们总结了这两种方法对胃肠生理的影响的当前知识，并评估了知识差距。并增加了胆汁酸的血清水平，但其对肠道pH值，固体胃排空，肠道运输时间，胃酶分泌和表面积的影响仍然未知。在这篇综述中，我们总结了这两种方法对胃肠生理的影响的当前知识，并评估了知识差距。并增加了胆汁酸的血清水平，但其对肠道pH值，固体胃排空，肠道运输时间，胃酶分泌和表面积的影响仍然未知。在这篇综述中，我们总结了这两种方法对胃肠生理的影响的当前知识，并评估了知识差距。