Virji Ayaz, Murr Michel M
Morton Plant Mease Primary Care Weight Management Clinic, Largo, Florida 33771, USA.
Am Fam Physician. 2006 Apr 15;73(8):1403-8.
Bariatric surgery leads to sustainable long-term weight loss and may be curative for such obesity-related comorbidities as diabetes and obstructive sleep apnea in severely obese patients. The Roux-en-Y gastric bypass has become the most common procedure for patients undergoing bariatric surgery. The procedure carries a mortality risk of up to 1 percent and a serious complication risk of up to 10 percent. Indications include body mass index of 40 kg per m2 or greater, or 35 kg per m2 or greater with serious obesity-related comorbidities (e.g., diabetes, obstructive sleep apnea, coronary artery disease, debilitating arthritis). Pulmonary emboli, anastomotic leaks, and respiratory failure account for 80 percent of all deaths 30 days after bariatric surgery; therefore, appropriate prophylaxis for venous thrombo-embolism (including, in most cases, low-molecular-weight heparin) and awareness of the symptoms of common complications are important. Some of the common short-term complications of bariatric surgery are wound infection, stomal stenosis, marginal ulceration, and constipation. Symptomatic cholelithiasis, dumping syndrome, persistent vomiting, and nutritional deficiencies may present as long-term complications.
减肥手术可带来可持续的长期体重减轻，对于重度肥胖患者的糖尿病和阻塞性睡眠呼吸暂停等肥胖相关合并症可能具有治愈作用。 Roux-en-Y胃旁路术已成为接受减肥手术患者最常用的术式。该手术的死亡风险高达1%，严重并发症风险高达10%。手术适应症包括体重指数达到每平方米40千克或更高，或体重指数每平方米35千克或更高且伴有严重肥胖相关合并症（如糖尿病、阻塞性睡眠呼吸暂停、冠状动脉疾病、致残性关节炎）。肺栓塞、吻合口漏和呼吸衰竭占减肥手术后30天内所有死亡病例的80%；因此，适当预防静脉血栓栓塞（在大多数情况下包括低分子量肝素）并了解常见并发症的症状很重要。减肥手术一些常见的短期并发症包括伤口感染、吻合口狭窄、边缘溃疡和便秘。有症状的胆石症、倾倒综合征、持续性呕吐和营养缺乏可能表现为长期并发症。
