Source: openalex · Zhi-Jie Qu, Shan Cong, Yang Cong, Yan Jiao, Ya-Hui Liu · World Journal of Gastrointestinal Surgery · 2026-05-27
URL: https://doi.org/10.4240/wjgs.v18.i5.118254
AI rationale (4/5, tier: emerging): Longitudinal microbiota dynamics post-intervention with mechanistic focus on dysbiosis-metabolic links; matches INCLUDE criteria despite heterogeneous findings.
Bariatric surgery is recognized as the most effective surgical strategy for achieving sustained weight loss and improving metabolic disorders in patients with severe obesity. Beyond anatomical restriction and caloric malabsorption, increasing evidence suggests that surgery-induced remodeling of the gut microbiota plays a critical role in mediating postoperative metabolic benefits. Initial studies primarily described global alterations in microbial diversity; however, subsequent research has revealed complex, procedure-specific, and time-dependent changes in microbial composition and function. Nevertheless, findings across studies remain heterogeneous, and the clinical and mechanistic relevance of these microbial shifts is not fully established. Key unresolved issues include inconsistent trajectories of microbial diversity from the early postoperative period to long-term follow-up, debated differences between Roux-en-Y gastric bypass and sleeve gastrectomy, and limited integration of microbial functional changes with host metabolic regulation. In particular, the causal links between microbiota remodeling and alterations in carbohydrate metabolism, bile acid signaling, and vitamin absorption remain incompletely understood, limiting translational application and microbiome-targeted interventions. In this minireview, we synthesize current clinical and experimental evidence on gut microbiota remodeling following bariatric surgery, with emphasis on species-specific alterations, temporal dynamics, and procedure-dependent metabolic consequences. We compare microbial responses across major surgical techniques, summarize short-and long-term patterns of microbiota adaptation, and integrate mechanistic insights involving microbial metabolites, bile acid metabolism, and gut hormone signaling. By consolidating longitudinal and multi-omics data, this review aims to clarify existing controversies, highlight surgery-specific microbial signatures, and identify future research directions relevant to optimizing metabolic outcomes and postoperative management in bariatric surgery.