Boškoski Ivo, Pontecorvi Valerio, Ibrahim Mostafa, Huberty Vincent, Maselli Roberta, Gölder Stefan K, Kral Jan, Samanta Jayanta, Patai Árpád V, Haidry Rehan, Hollenbach Marcus, Pérez-Cuadrado-Robles Enrique, Silva Marco, Messmann Helmut, Tham Tony C, Bisschops Raf
Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt.
Endoscopy. 2023 Mar;55(3):276-293. doi: 10.1055/a-2003-5818. Epub 2023 Jan 25.
Obesity is a chronic, relapsing, degenerative, multifactorial disease that is associated with many co-morbidities. The global increasing burden of obesity has led to calls for an urgent need for additional treatment options. Given the rapid expansion of bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This curriculum is set out in terms of the prerequisites prior to training, minimum number of procedures, the steps for training and quality of training, and how competence should be defined and evidenced before independent practice. 1: ESGE recommends that every endoscopist should have achieved competence in upper gastrointestinal endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. 2: Trainees in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery should have basic knowledge of the definition, classification, and social impact of obesity, its pathophysiology, and its related co-morbidities. The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory. 3 : ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.
肥胖是一种慢性、复发性、退行性、多因素疾病，与许多合并症相关。全球肥胖负担日益加重，人们迫切需要更多的治疗选择。鉴于减肥内镜检查和减肥手术在欧洲迅速普及，欧洲胃肠内镜学会（ESGE）认识到有必要规范和加强减肥内镜检查以及减肥手术不良事件的内镜治疗方面的培训。本手稿代表了正式德尔菲过程的结果，形成了ESGE的官方立场声明，并提供了一个框架，用于培养和维持减肥内镜检查以及减肥手术不良事件的内镜治疗技能。本课程从培训前的先决条件、最少手术例数、培训步骤和培训质量，以及在独立执业前应如何定义和证明能力等方面进行了阐述。1：ESGE建议，每位内镜医师在开始减肥内镜检查和减肥手术不良事件的内镜治疗培训之前，应已具备上消化道内镜检查的能力。2：减肥内镜检查及减肥手术并发症内镜治疗的学员应具备肥胖的定义、分类和社会影响、病理生理学及其相关合并症的基础知识。认识和管理肥胖患者中更常见的胃肠道疾病，以及参与评估肥胖患者的多学科团队，是必不可少的。3：ESGE建议，减肥内镜检查及减肥手术并发症内镜治疗的能力可通过首先参加经认证的模拟器培训课程、结构化培训课程，然后在三级转诊中心进行实践培训来获得。
