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(A) Taking sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) as the archetypal examples of metabolic bariatric operations, both procedures lead to a net increase of endogenous GLP-1 with different mechanisms: LSG via rapid gastric emptying and RYGB due to the presence of undigested nutrients in the intestinal lumen in segments rich in L-cells, such as the ileum[45,46]
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