减重外科的发展历程及前景

随着肥胖问题的日益严重以及微创减重手术的发展，减重手术在近年来呈现跳跃式的发展，也发展出独立的减重外科分支。减重手术不但是病态性肥胖患者目前唯一有效的治疗方法，而且逐渐发展为代谢性手术，为难治性的肥胖合并糖尿病患者提供了一种新的治疗方法。减重手术的术式数十年发生了很大的变化，目前的减重手术经过不断的改进及发展，已成为一种相对安全和有效的外科治疗方法。新的代谢性手术仍在不断地发展，预期对未来糖尿病的治疗会有很大的突破。减重外科的专科化发展则是减重手术蓬勃发展后的必然趋势，独立的减重外科可以专注于减重手术的服务以及质量提升，对减重及代谢手术的专业训练以及研究发展也都有很大的帮助。随着文明化生活方式的影响，肥胖及糖尿病将会持续成为这个时代重要的健康问题，减重外科的发展更是值得期待。

History and prospect of bariatric surgery

With the coming of obesity epidemic and the development of mini-invasive bariatric surgery, we have entered an era where bariatric surgery growing in an exponential way and becoming an independent surgical division. Bariatric surgery is not only the single effective treatment for morbid obese patients （ BMI 〉 35 kg/m2 ）, but also transforming into metabolic surgery for the treatment of not well controlled type 2 diabetes in obese patients with BMI 〈 35 kg/m2. The type of bariatric procedure had changed a lot in the past decades. Current bariatric surgery is not only very safe but also very effective. Many new metabolic surgeries and procedures have also been developed and a great break-through in diabetes treatment is expected in the future. Bafiatric/Metabolic surgical division is a consequence of the rapid growing bariatric surgeries. An independent Bariatric/ Metabolic surgical division may focus on a high quality bariatric surgical service, provide the education and training of bariatric surgeons, and help in research and development of this field. As obesity and associated diabete is becoming the most important health issue in the modem world, a continuing development of Bariatric/Metabolic surgery is expecting.