Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
World J Gastroenterol. 2022 Jan 14;28(2):199-215. doi: 10.3748/wjg.v28.i2.199.
Obesity rates continue to climb worldwide. Obesity often contributes to other comorbidities such as type 2 diabetes, hypertension, heart disease and is a known risk factor for many malignancies. Bariatric surgeries are by far the most invasive treatment options available but are often the most effective and can result in profound, durable weight loss with improvement in or resolution of weight associated comorbidities. Currently performed bariatric surgeries include Roux-en-Y gastric bypass, sleeve gastrectomy, and laparoscopic gastric banding. These surgeries are associated with significant weight loss, but also with significant rates of major complications. The complexity of these patients and surgical anatomies makes management of these complications by a multidisciplinary team critical for optimal outcomes. Minimally invasive treatments for complications are typically preferred because of the high risk associated with repeat operations. Endoscopy plays a large role in both the diagnosis and the management of complications. Endoscopy can provide therapeutic interventions for many bariatric surgical complications including anastomotic strictures, anastomotic leaks, choledocholithiasis, sleeve stenosis, weight regain, and eroded bands. Endoscopists should be familiar with the various surgical anatomies as well as the various therapeutic options available. This review article serves to delineate the current role of endoscopy in the management of complications after bariatric surgery.
肥胖率在全球范围内持续攀升。肥胖症通常会导致其他合并症，如 2 型糖尿病、高血压、心脏病，并且是许多恶性肿瘤的已知危险因素。到目前为止，减肥手术是最具侵入性的治疗选择，但通常也是最有效的，可以导致显著、持久的体重减轻，并改善或解决与体重相关的合并症。目前进行的减肥手术包括 Roux-en-Y 胃旁路术、袖状胃切除术和腹腔镜胃带术。这些手术与显著的体重减轻相关，但也与重大并发症的发生率较高相关。这些患者和手术解剖结构的复杂性使得多学科团队对这些并发症的管理对获得最佳结果至关重要。由于与重复手术相关的高风险，微创治疗并发症通常是首选。内窥镜在并发症的诊断和管理中都起着重要作用。内窥镜可以为许多减肥手术并发症提供治疗干预，包括吻合口狭窄、吻合口漏、胆总管结石、袖状狭窄、体重反弹和带侵蚀。内窥镜医师应熟悉各种手术解剖结构以及可用的各种治疗选择。本文旨在阐述内窥镜在减肥手术后并发症管理中的当前作用。
