Bidares Matin, Aziz Mahsa, Samadzadeh Sara, Hosseini Nastaran, Bidares Ramtin
Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Obes Surg. 2025 Sep 2. doi: 10.1007/s11695-025-08192-x.
Bariatric surgery is a widely used treatment for morbid obesity, but it can lead to neurological complications, including Guillain-Barré Syndrome (GBS), a rare immune-mediated polyneuropathy. The mechanisms underlying post-bariatric GBS remain unclear, and no comprehensive review has evaluated its incidence, risk factors, and outcomes. This systematic review synthesizes available clinical data to assess the relationship between bariatric surgery and GBS, focusing on its presentation, diagnosis, and management. A systematic literature search was conducted in Web of Science, PubMed, and Scopus following PRISMA guidelines. Studies reporting GBS following bariatric surgery were included. Data extraction focused on demographics, clinical presentation, laboratory findings, treatment approaches, and outcomes. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. GBS cases were predominantly reported in female patients, with symptom onset occurring within weeks to months post-surgery. The most common clinical features included ascending motor weakness, sensory disturbances, hyporeflexia, and autonomic dysfunction. Laboratory findings showed elevated cerebrospinal fluid protein and abnormal nerve conduction studies. Patients were treated with intravenous immunoglobulin (IVIG), plasmapheresis, and nutritional supplementation, particularly thiamine and vitamin B12. Recovery varied; some patients regained full function, while others experienced persistent neurological deficits or severe complications such as respiratory failure. GBS is a rare but serious post-operative complication of bariatric surgery, potentially linked to immune dysregulation and nutritional deficiencies. Early recognition and prompt intervention are critical. Further research is needed to clarify underlying mechanisms, optimize treatment, and improve preventive strategies.
减肥手术是一种广泛应用于治疗病态肥胖症的方法，但它可能导致神经并发症，包括吉兰-巴雷综合征（GBS），这是一种罕见的免疫介导性多发性神经病。减肥术后GBS的潜在机制尚不清楚，且尚无全面综述评估其发病率、危险因素及预后情况。本系统综述综合现有临床数据，以评估减肥手术与GBS之间的关系，重点关注其临床表现、诊断及治疗。按照PRISMA指南，在科学网、PubMed和Scopus数据库中进行了系统的文献检索。纳入了报道减肥手术后发生GBS的研究。数据提取集中在人口统计学、临床表现、实验室检查结果、治疗方法及预后。使用乔安娜·布里格斯研究所（JBI）工具评估研究质量。GBS病例主要见于女性患者，症状在术后数周数月内出现。最常见的临床特征包括进行性运动无力、感觉障碍、反射减退及自主神经功能障碍。实验室检查结果显示脑脊液蛋白升高及神经传导研究异常。患者接受了静脉注射免疫球蛋白（IVIG）、血浆置换及营养补充，尤其是硫胺素和维生素B12。恢复情况各不相同；一些患者恢复了全部功能，而另一些患者则出现持续性神经功能缺损或严重并发症，如呼吸衰竭。GBS是减肥手术一种罕见但严重的术后并发症，可能与免疫失调和营养缺乏有关。早期识别和及时干预至关重要。需要进一步研究以阐明潜在机制、优化治疗并改进预防策略。
