Crookes Peter F
Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
Annu Rev Med. 2006;57:243-64. doi: 10.1146/annurev.med.56.062904.144928.
Obesity is a major epidemic in developed countries. It induces or exacerbates hypertension, diabetes mellitus, obstructive sleep apnea, dyslipidemia, and many other disease processes, which cumulatively contribute to premature mortality on a scale rivaling that of smoking. At present, bariatric surgery is the only therapeutic modality that can produce sustained weight loss and halt or resolve comorbidities. This success results from the ability to perform the operation reliably, usually laparoscopically, with low mortality. The most commonly performed operation is Roux-en-Y gastric bypass. Other bypasses discussed in this review include biliopancreatic diversion with and without duodenal switch. Purely restrictive operations, especially adjustable gastric banding, have a lower risk but are somewhat less effective. We focus on the more controversial aspects of commonly accepted operations, including patient selection, the spectrum and frequency of complications, and the long-term outcome.
肥胖是发达国家的一种主要流行病。它会诱发或加剧高血压、糖尿病、阻塞性睡眠呼吸暂停、血脂异常以及许多其他疾病进程，这些疾病综合起来导致的过早死亡率堪比吸烟。目前，减肥手术是唯一能够实现持续体重减轻并停止或解决合并症的治疗方式。这种成功源于能够可靠地进行手术，通常是通过腹腔镜手术，且死亡率较低。最常施行的手术是Roux-en-Y胃旁路术。本综述中讨论的其他旁路手术包括带或不带十二指肠转位的胆胰分流术。单纯的限制性手术，尤其是可调节胃束带术，风险较低但效果稍差。我们关注公认手术中更具争议性的方面，包括患者选择、并发症的范围和发生率以及长期结果。
