Qu ZJ, Cong S, Cong Y, Jiao Y, Liu YH. Microbiota remodeling after bariatric surgery: Procedure-specific dynamics and metabolic implications. World J Gastrointest Surg 2026; 18(5): 118254 [DOI: 10.4240/wjgs.v18.i5.118254]
Corresponding Author of This Article
Ya-Hui Liu, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. yahui@jlu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Qu ZJ, Cong S, Cong Y, Jiao Y, Liu YH. Microbiota remodeling after bariatric surgery: Procedure-specific dynamics and metabolic implications. World J Gastrointest Surg 2026; 18(5): 118254 [DOI: 10.4240/wjgs.v18.i5.118254]
World J Gastrointest Surg. May 27, 2026; 18(5): 118254 Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.118254
Microbiota remodeling after bariatric surgery: Procedure-specific dynamics and metabolic implications
Zhi-Jie Qu, Shan Cong, Yang Cong, Yan Jiao, Ya-Hui Liu
Zhi-Jie Qu, Shan Cong, Yang Cong, Department of Nephropathy, Second Hospital of Jilin University, Changchun 130022, Jilin Province, China
Yan Jiao, Ya-Hui Liu, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Co-corresponding authors: Yan Jiao and Ya-Hui Liu.
Author contributions: Qu ZJ led the literature search and manuscript drafting; Cong S collated and verified literature data; Cong Y sorted multi-omics data and produced visual materials; Jiao Y and Liu YH guided the review direction and made key decisions, with Liu YH reviewing and approving the final manuscript. All authors approved the final version. Designating Jiao Y and Liu YH as co-corresponding authors is scientifically and organizationally justified based on their complementary leadership roles and sustained intellectual contributions throughout the development of this minireview. As outlined in the author contributions section, both authors jointly guided the overall conceptual framework, scope, and scholarly direction of the review, ensuring balanced coverage of bariatric surgical procedures, gut microbiota remodeling, and metabolic implications. Jiao Y provided critical expertise in hepatobiliary and pancreatic surgery, contributing to the clinical interpretation of bariatric procedures and postoperative metabolic outcomes, while Liu YH contributed substantial oversight in gastrointestinal surgery and ensured methodological rigor and coherence across sections. Importantly, Liu YH also undertook final manuscript review and approval, taking responsibility for the integrity of the submitted version. The designation of co-corresponding authors therefore reflects shared senior responsibility, equal accountability for academic content, and joint stewardship of correspondence with the journal and readers, consistent with international authorship guidelines and the actual division of intellectual leadership in this work.
AI contribution statement: ChatGPT was used only for language polishing and improving the clarity and readability of the manuscript.
Conflict-of-interest statement: There is no conflict of interest.
Corresponding author: Ya-Hui Liu, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. yahui@jlu.edu.cn
Received: December 28, 2025 Revised: January 21, 2026 Accepted: February 2, 2026 Published online: May 27, 2026 Processing time: 151 Days and 7.3 Hours
Abstract
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.
Core Tip: Emerging evidence indicates that bariatric surgery reshapes the gut microbiota in a procedure-specific and time-dependent manner, extending its metabolic benefits beyond anatomical restriction and caloric malabsorption. This minireview synthesizes current clinical and experimental data to highlight surgery-specific microbial signatures, longitudinal remodeling patterns, and key mechanistic links to bile acid signaling, carbohydrate metabolism, and micronutrient handling. By integrating species-level and functional insights, we emphasize existing controversies and translational considerations relevant to optimizing postoperative metabolic outcomes.
