国际胃袖状切除专家共识:基于>12000手术病例的最佳操作指南

International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases

腹腔镜胃袖状切除术（1aparoscopic sleeve gastrectomy，LSG）系相对较新的减重手术方式。因其操作相对简单、治疗肥胖合并疾病及减重效果明显，逐步得以广泛接受。目前美国代谢与减重手术协会将其推荐为肥胖症治疗的单独标准术式。2011年3月25～26日，

Background Laparoscopic sleeve gastrectomy （LSG） is an emerging surgical approach, but 1 that has seen a surge in popularity because of its perceived technical simplicity, feasibility, and good outcomes. An international expert panel was convened in Coral Gables, Florida on March 25 and 26, 2011, with the purpose of providing best practice guidelines through consensus regarding the performance of LSG. The panel comprised 24 centers and represented 11 countries, spanning all major regions of the world and all 6 populated continents, with a collective experience of 〉 12,000 cases. It was thought prudent to hold an expert consensus meeting of some of the surgeons across the globe who have performed the largest volume of cases to discuss and provide consensus on the indications, contraindieations, and procedural aspects of LSG. The panel undertook this consensus effort to help the surgical community improve the efficacy, lower the complication rates, and move toward adoption of standardized techniques and measures. The meeting took place at on-site meeting facilities, Biltmore Hotel, Coral Gables, Florida. Methods Expert panelists were invited to participate according to their publications, knowledge and experience, and identification as surgeons who had performed 〉500 cases. The topics for consensus encompassed patient selection, contraindications, surgical technique, and the prevention and management of complications. The responses were calculated and defined as achieving consensus （/〉70% agreement） or no consensus （ 〈 70% agreement）. Results Full consensus was obtained for the essential aspects of the indications and eontraindications, surgical technique, management, and prevention of complications. Consensus was achieved for 69 key questions. Conclusion The present consensus report represents the best practice guidelines for the performance of LSG, with recommendations in the 3 aforementioned areas. This report and its findings support a first effort toward the standardization of techniques and adoption of working recommendations formulated according to expert experience.