腹腔镜减重与代谢外科治疗现状与发展

The Current Status and Future Development of Laparoscopic Metabolic and Bariatric Surgery

减重与代谢外科从最初的以减重为唯一目的,发展到治疗肥胖相关的糖、脂代谢和内分泌紊乱,手术适应证不断拓展,治疗范围涵盖2型糖尿病、非酒精性脂肪性肝病、睡眠呼吸暂停综合征等,手术所要求的身体质量指数不断调低。学科内涵不断丰富,对经典手术方式包括Roux-en-Y胃旁路术、胃袖状切除术、可调节胃绑带术和胆胰分流并十二指肠转位术的认识不断加深,在此基础上,新的手术方式不断涌现,包括袖状胃加单吻合口十二指肠转位手术和单吻合口胃旁路手术等。同时,减重外科未来也面临减重器械和胃镜下治疗的挑战。

Metabolic and bariatric surgery has developed from the original purpose solely for weight reduction to the treatment of obesity related glucose, lipid metabolism and endocrine disorders. The indications for the surgery are constantly expanding, and the treatment scope covers type 2 diabetes, non-alcoholic fatty liver disease, sleep apnea syndrome, and so on. In addition, the body mass index requirement for eligibility of the surgery has been constantly reduced. At the same time, the connotation is constantly being enriched along with profound understanding of conventional surgical procedures including Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric banding, as well as biliopancreatic diversion with duodenal switch surgery and one anastomosis gastric bypass surgery. However, the future of metabolic and bariatric surgery also faces the challenges of weight-loss surgical devices and endoscopic treatment innovations.