Abstract: Indication and choice of bariatric surgical procedures of bariatric surgery for adolescent obesity        LIANG Hui.  Department of Bariatric and Metabolic Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China
Abstract    The prevalence of adolescent obesity is increasing annually in China. And it has become the health burden of socioeconomic development. Conservative treatment for severe adolescent obesity has limited therapeutic outcomes. However，due to physiological and psychological immaturity in the adolescent，bariatric surgery for the treatment of adolescent obesity has not gain wide acceptance in China. Despite limited clinical evidence，bariatric surgery for the treatment of adolescent obesity was proven to be safe and effective with low postoperative complications. The bariatric surgery is indicated mainly for the adolescent obesity with BMI≥32.5 with comorbidities. The recommendation of surgical procedures is sleeve gastrectomy and gastric bypass，while sleeve gastrectomy is considered to be the preferred choice. It is necessary to evaluate physiological and psychological maturity preoperatively. Meanwhile，postoperative life style correction and scheduled follow-up for the treatment of surgical and nutritional complications are also required. Though bariatric surgery for the treatment of adolescent obesity is less developed and has lower acceptance，it will become the most effective method for treating adolescent obesity with the accumulation of more and more high-quality clinical studies.

Key words: adolescent, obesity, bariatric surgery, indication, surgical procedures

摘要： 我国青少年肥胖发病率逐年升高，越来越受到全社会的重视。青少年重度肥胖保守治疗效果有限，但由于青少年生理、心理尚不成熟，行减重手术治疗青少年肥胖尚未获得广泛接受。有限的临床证据表明，行减重手术治疗青少年肥胖安全有效，并发症发生率较低，主要适用于BMI≥32.5且有合并症的青少年肥胖病人，手术方式推荐胃袖状切除术和胃旁路术，其中胃袖状切除术为首选术式。术前须仔细评估病人的生理及心理成熟度，术后须配合生活方式矫正，并随访治疗手术并发症及营养并发症。虽然减重手术治疗青少年肥胖开展少，接受度低，但随着越来越多高质量临床研究的开展，减重手术必将成为治疗青少年肥胖最有效的手段。

关键词: 青少年, 肥胖, 减重手术, 适应证, 手术方式