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减重手术的修正术式和并发症处理。

Revision Bariatric Procedures and Management of Complications from Bariatric Surgery.

机构信息

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, 02115, USA.

Harvard Medical School, Boston, MA, 02115, USA.

出版信息

Dig Dis Sci. 2022 May;67(5):1688-1701. doi: 10.1007/s10620-022-07397-9. Epub 2022 Mar 26.

Abstract

Bariatric surgery is effective, but may be associated with adverse events. A multi-disciplinary approach including endoscopic interventions can be effective to manage these. Endoscopists should familiarize themselves with gastrointestinal pathology which can occur after bariatric surgery, including nutritional deficiencies, acid reflux, anastomotic stenosis, gallstone disease, leaks, fistulas, and weight regain. Endoscopic interventions including anastomotic stricture dilation, control of bleeding, endoscopic ultrasound-guided approach for endoscopic retrograde cholangiopancreatography, leak or fistula closure via endoscopic suturing or stent placement, and transoral outlet reduction (TORe) or revision obesity surgery endoluminal (ROSE) to address weight regain are among the endoscopic tools which have demonstrated safety and efficacy in the management of adverse events after bariatric surgery.

摘要

减重手术有效,但可能与不良事件相关。多学科方法,包括内镜介入,可以有效管理这些不良事件。内镜医生应该熟悉胃旁路手术后可能发生的胃肠道病理学,包括营养缺乏、胃酸反流、吻合口狭窄、胆石病、漏、瘘和体重反弹。内镜干预措施包括吻合口狭窄扩张、控制出血、内镜超声引导下内镜逆行胰胆管造影、经内镜缝合或支架置入闭合漏或瘘、经口腔出口缩小术(TORe)或修改肥胖手术内镜(ROSE)以解决体重反弹,这些内镜工具已被证明在管理减重手术后的不良事件方面是安全有效的。

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