2026年 · 第41卷第08期

Time flies, and before I knew it, I had known my mentor, Professor Peng Shuyou, for more than 40 years. His lifelong love for clinical practice, his unwavering commitment to innovation in scientific research, his selfless dedication to education, his meticulous care for patients, and his open-minded optimism about life have illuminated my path like a torch, constantly inspiring me to think and delve into the field of surgery, prompting me and my team to break with convention, constantly innovate, strive for excellence, and achieve outstanding results. The moments I experienced with my teachers during my student days and the period of expanding my territory are the most important assets in my life.

The 42nd ASMBS Annual Meeting was held from May 3 to 7, 2026, at the Henry B. González Convention Center in San Antonio, Texas. This year's annual meeting, themed "No One Left Behind," profoundly reflects the paradigm shift in weight loss and metabolic surgery from technology-driven to patient-centered, precise matching, and full-process management.

A 29-year-old female patient was admitted to the hospital due to "abdominal pain with vomiting, cessation of exhaust, and defecation for 1 d". Physical examination: total abdominal distension, mild tenderness in the left middle abdomen, no rebound pain and muscle tension in the whole abdomen, and a tough mass of about 10 cm can be palpated in the left middle abdomen. Whole abdomen percussion drum sounds, intestinal sounds 5 times/min. Laboratory tests: Hematology: White blood cell count 11.0 × 10⁹/L, the percentage of neutrophils was 86.4%. Serum amylase 425.3 U/L, alanine aminotransferase 6.7 U/L, bilirubin 15.2 μmol/L, lipase 106 U/L. Whole abdominal contrast-enhanced CT examination showed: enlarged pancreatic tail with peripheral edema and exudation, flat bilateral fluid in the fundus of the stomach, and splenomegaly, located in the left middle abdomen with compression stenosis of the colon in the splenic region (Figures 1 and 2). Preliminary diagnosis: (1) acute pancreatitis; (2) gastric torsion; (3) colon obstruction; (4) Splenomegaly. Gastrointestinal decompression, ceftriaxone anti-infection, somatostatin and fluid replacement were given. After 3 days, the symptoms were relieved, and after the laboratory indicators were normal, the gastric tube was removed and a semi-liquid diet was started. Five days later, a reexamination of the whole abdominal CT scan showed that the edema and exudation of the pancreatic tail had improved, the spleen had moved down to the pelvic cavity, the spleen pedicle had no torsion, the stomach was located in the left middle abdomen, and the biliary fluid was still flat, and there was no obvious dilation of the colon (Figure 3). It was diagnosed as a wandering spleen. The patient had no abdominal pain, nausea, or vomiting after eating, normal anal exhaust and defecation, and no torsion necrosis of the spleen. The patient was discharged from the hospital and instructed to avoid strenuous exercise and postpone fertility.

A 21-year-old female patient was admitted to the hospital due to "progressive weight gain for more than 5 years". Physical examination: Blood pressure 120/58 mmHg, height 163 cm, weight 96 kg, BMI 36.13 kg/m². Laboratory tests: serum ALT23U/L, AST20U/L, glutamyl transferase 34 U/L, total bilirubin 3.1 umol/L, direct bilirubin 0.9 μmol/L, creatinine 49 umol/L, uric acid 628 μmol/L. Diagnosis: Metabolic syndrome, obesity, hyperuricemia. Laparoscopic sleeve gastrectomy was performed. On the 5th postoperative day, the patient experienced nausea, vomiting, oliguria and generalized edema. Urgent biochemical indicators showed: serum ALT4631U/L, AST1113U/L, glutamyl transferase 115 U/L, total bilirubin 26.2 umol/L, direct bilirubin 14.3 μmol/L, creatinine 836 umol/L. Diagnosis: Acute liver failure, acute renal failure. After liver-protective treatment and two "plasma exchange + perfusion" sessions, the patient's serum ALT and AST decreased, and the serum creatinine level remained at around 900 μmol/L. In view of the stabilization of liver function, the patient was transferred to the nephrology department for regular dialysis treatment, and the serum creatinine level steadily decreased. One month later, the serum ALT 33U/L, AST59U/L, glutamyl transferase 46 U/L, total bilirubin 10.5 umol/L, direct bilirubin 2.7 μmol/L, and creatinine 97 umol/L were reexamined.