关键词: 减重与代谢手术, 机制, 单吻合口十二指肠-回肠旁路术, 胃袖状切除术, 单吻合口胃旁路术, 十二指肠-空肠旁路术, 空肠-空肠旁路术, 内镜胃袖状成形术, 肥胖, 糖尿病

Abstract: Advances in the mechanism of new procedures in metabolic and bariatric surgery        ZHANG Pin, BAN Xu-yan, ZHAG  Hong-wei, et al. Department of Bariatric and Metabolic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
Corresponding author: DI Jian-zhong, E-mail: dijianzhong@
sjtu.edu.cn
Abstract    Obesity is a serious global health problem with a huge socio-economic burden. Obesity is also a risk factor for many chronic diseases. Bariatric surgery is the most effective way to treat obesity. The most recent mechanisms of action in several bariatric surgeries performed worldwide, including single anastomosis duodenal-ileal bypass with sleeve, one anastomosis gastric bypass, duodenojejunal bypass, jejune-jejunal bypass, and endoscopic sleeve gastroplasty. Surgery achieves weight loss mainly through restriction of intake, malabsorption or a combination of both, and can affect appetite, alter ingestive habits, influence metabolism by altering levels of gastrointestinal hormones, bile acid secretion, and postoperative intestinal flora changes may be additional mechanisms for surgery. In the author’s opinion, single anastomosis duodenal-ileal bypass with sleeve gastrectomy and one anastomosis gastric bypass are more recommendable.

Key words: metabolic and bariatric surgery, mechanism, single anastomosis duodenal-ileal bypass, sleeve gastrectomy, one anastomosis gastric bypass, duodeno-jejunal bypass, jejune-jejunal bypass, endoscopic sleeve gastroplasty, obesity, diabetes mellitus