Bariatric and metabolic surgery: An experience summarization of 1139 cases from a single center        LIANG Hui，GUAN Wei，LIN Shi-bo，et al. Department of Bariatric and Metabolic Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China
Corresponding author：LIANG Hui，E-mail：drhuiliang@126.com
Abstract    Objective    To summarize the experience of bariatric and metabolic surgery in a single center from 2009 to 2017 and explore the methods of the specialty construction of bariatric and metabolic surgery. Methods    The clinical data of 1139 cases of bariatric and metabolic procedures performed from October 2009 to December 2017 in Department of Bariatric and Metabolic Surgery，the First Affiliated Hospital of Nanjing Medical University  were analyzed retrospectively. Results    The case numbers increased annually after the foundation of bariatric and metabolic surgery with the annual growth rate of 40.1%. Bleeding and leakage were the main postoperative complications. Among them，there was one case of postoperative death，6 cases of re-operations within the 30-day after discharge，and 21 cases of 30-day postoperative readmission. The learning curve analysis indicated that learning time was 23 cases for laparoscopic gastric bypass and 25 cases for sleeve gastrectomy. The rates of 1-year excessive weight loss were 83.0% for gastric bypass，72.4% for sleeve gastrectomy，and 82.3% for sleeve gastrectomy plus jejunal bypass. The rates of 1，3 and 5-year follow-up were around 95.0%，67.0% and 52.0%. Conclusion    The foundation of bariatric and metabolic specialty is the key reason for the massive increase of surgical cases. The learning curve of laparoscopic bariatric and metabolic surgery can be shortened though systemic specialty training. The collaboration of multi-disciplinary team and the perioperative process management are the key points for the construction of an excellent center.