袖状胃切除术后胃食管反流病诊治中日韩专家上海共识(2024版)

Shanghai consensus on the diagnosis and treatment of gastroesophageal reflux disease in patients undergoing sleeve gastrectomy(2024 edition)

病态肥胖及其伴随疾病已是全世界需要共同面对的最严重的公共卫生问题之一,而减重代谢手术到目前为止仍是长期控制体质量最有效的方法。在所有的减重术式中,袖状胃切除术是目前应用最广的一种,但它并不是完美的术式。术后可能加重原有的或出现新发的胃食管反流病一直是这种术式所要面对的最严重的问题之一。而且,目前关于袖状胃切除术患者胃食管反流病的诊治方面还缺乏高级别临床实验的证据。因此,由国内四家减重手术中心发起,来自中国、日本和韩国的41位在减重代谢手术及胃食管反流诊治方面有丰富经验的专家,以Delphi法来达成“袖状胃切除术患者胃食管反流病诊治的共识”。本共识中共有59个征询问题,其中44个达成共识。期待本共识不仅能作为临床诊治的参考依据,也能为未来高质量临床研究提供更多可能的方向。

Morbid obesity and its accompanying diseases have become one of the most serious public health problems warranting global effort and bariatric and metabolic surgery is still the most effective method for long-term weight control.Among all bariatric and metabolic procedures,sleeve gastrectomy is currently the most widely used,but it is not a perfect procedure.One of the most serious issues that this surgical procedure faces is the possibility of worsening existing or developing de novo gastroesophageal reflux disease after surgery.Moreover,there is currently a lack of high-level clinical trial evidence on the diagnosis and treatment of gastroesophageal reflux disease in patients undergoing sleeve gastrectomy.Therefore,initiated by four domestic bariatric and metabolic surgery centers,41 experts with rich experience in bariatric and metabolic surgery and diagnosis and treatment of gastroesophageal reflux disease from China,Japan,and South Korea reached a consensus on the diagnosis and treatment of gastroesophageal reflux disease in sleeve gastrectomy patients using the Delphi method.There are a total of 59 consultation questions in this consensus,of which 44 have reached a consensus.We hope that this consensus can not only serve as a reference for clinical diagnosis and treatment,but also provide more possible directions for future high-quality clinical research.