為什麼術前評估這麼重要？
Why Is Pre-operative Evaluation So Important?
代謝減重手術是一項安全性高、效益顯著的治療方式——但「安全」不是偶然的，它來自手術前嚴謹的系統性評估。
Metabolic bariatric surgery has an excellent safety profile and meaningful outcomes — but that safety doesn't happen by accident. It is the result of rigorous, systematic pre-operative evaluation.
肥胖症患者的身體狀況往往比體重數字更複雜：可能有尚未診斷的糖尿病、潛伏的甲狀腺問題、脂肪肝、心臟負荷異常、電解質失衡，或者從未被發現的荷爾蒙疾病。這些問題如果在手術前沒有被找出來並妥善處理，就可能在術中或術後成為風險。
Patients with obesity often have a far more complex physiological picture than their weight alone suggests: undiagnosed diabetes, subclinical thyroid disease, fatty liver, cardiac strain, electrolyte imbalances, or hormonal conditions that have never been detected. Unaddressed, these can become peri-operative risks.
術前評估的目的不是「篩掉」不適合的患者，而是充分了解每位患者的個別狀況，確認問題、解決問題，讓手術在最安全的條件下進行。絕大多數評估中發現的異常，都有對應的處理方案。
The purpose of pre-operative evaluation is not to screen patients out, but to fully understand each individual's condition, identify issues, address them, and ensure the operation proceeds under the safest possible conditions. The vast majority of abnormalities found during evaluation have corresponding management plans.
🏥 聯合門診：一次門診，多專科的完整評估
🏥 Multidisciplinary Clinic: One Appointment, Multiple Specialties
在高雄長庚體重管理中心，術前評估不是只有外科醫師的單一意見。我們安排專屬的聯合門診，讓準備接受手術的患者，在同一次門診時間內接受多個專科的協同評估——確保每一個面向的健康狀況都被完整考量，手術計畫也能真正做到個人化。
At the CGMH Weight Management Centre, pre-operative evaluation goes beyond a single surgeon's assessment. We arrange a dedicated multidisciplinary clinic where patients preparing for surgery receive coordinated evaluation from multiple specialties in a single appointment — ensuring every dimension of health is fully considered and the surgical plan is truly personalised.
評估手術適應症、術式選擇與手術計畫，說明術前準備事項與術後恢復流程，並整合所有評估結果做出最終的手術決策。
Evaluates surgical indications, procedure selection and surgical plan; explains pre-operative preparation and post-operative recovery; and integrates all evaluation findings to reach the final surgical decision.
針對代謝與荷爾蒙方面進行深入評估，包括血糖控制、甲狀腺功能、以及其他可能影響體重或手術安全的內分泌問題。對於合併糖尿病或其他代謝疾病的患者尤為重要。
Provides in-depth assessment of metabolic and hormonal status, including glycaemic control, thyroid function, and other endocrine conditions that may affect weight or surgical safety. Particularly important for patients with diabetes or other metabolic comorbidities.
評估患者的心理健康狀態與手術準備度，了解飲食行為模式、壓力因應能力，以及對術後生活改變的心理準備。手術成功不只是身體上的改變——心理層面的準備同樣關鍵，這也是我們聯合門診的重要一環。
Assesses psychological wellbeing and surgical readiness, exploring eating behaviour patterns, stress management capacity, and psychological preparation for post-operative life changes. Surgical success is not only physical — psychological preparedness is equally critical, and this is why psychosomatic evaluation is a core part of our multidisciplinary clinic.
聯合門診的設計，是為了讓您不需要在不同科別間奔波，也不需要自己整合不同醫師的意見。我們的團隊在同一個時間、同一個地方，共同為您做出最完整的評估與規劃。
The multidisciplinary clinic is designed so you don't need to navigate between different departments or piece together opinions from different doctors on your own. Our team comes together at the same time and place to deliver the most complete evaluation and plan for you.
❤️ 心臟血管評估：手術最重要的安全門檻
❤️ Cardiovascular Evaluation: The Most Critical Safety Threshold
全身麻醉與手術本身對心臟都是一種考驗。肥胖患者發生心臟相關問題的比例高於一般人，許多問題在日常生活中沒有症狀，只有在系統性評估時才會被發現。
General anaesthesia and surgery both place demands on the heart. Patients with obesity have a higher baseline prevalence of cardiac conditions, many of which are asymptomatic in daily life and only discovered through systematic evaluation.
為什麼要做：評估心律與傳導功能，確認心臟在麻醉前的基本狀態。若有發現需要關注的問題，我們會在手術前妥善處理。
Why we do it: Evaluates cardiac rhythm and conduction function, confirming the heart's baseline status before anaesthesia. Any findings requiring attention are addressed before surgery proceeds.
為什麼要做：評估心臟的泵血功能與結構狀況。肥胖患者的心臟常長期承受額外負荷，超音波能發現心電圖看不到的問題，讓我們在術前掌握更完整的心臟狀況。
Why we do it: Assesses cardiac pump function and structural status. The hearts of patients with obesity often bear chronic extra load — echocardiography reveals structural findings invisible to EKG alone, giving us a more complete pre-operative picture.
若心電圖或超音波發現疑似缺血性變化，或患者有多重心血管危險因子（糖尿病、高血壓、高血脂、吸菸史），我們會進一步安排核醫鉈掃描，評估心肌血流灌注是否正常。這項檢查能在症狀出現前偵測出冠狀動脈疾病，是手術前最重要的心臟安全把關之一。
If EKG or echo reveals findings suggestive of ischaemia, or if the patient has multiple cardiovascular risk factors (diabetes, hypertension, dyslipidaemia, smoking history), we arrange nuclear thallium perfusion scanning to assess myocardial blood flow. This detects coronary artery disease before symptoms develop — one of the most important cardiac safety checks before major surgery.
🩸 血液健康與感染篩查
🩸 Blood Health & Infection Screening
全血球計數看起來平凡，卻能揭示許多影響手術安全的問題。貧血會影響麻醉耐受性與傷口癒合；感染或慢性發炎會升高手術風險；肝炎需要術前評估與管理。
A complete blood count may seem routine, but it reveals much that matters for surgical safety. Anaemia compromises anaesthetic tolerance and wound healing; infection or chronic inflammation elevates surgical risk; hepatitis requires pre-operative assessment and management.
為什麼要做：評估是否有貧血、感染或凝血相關問題。貧血會影響麻醉耐受性與術後恢復；若有需要，我們會在術前安排補充治療。
Why we do it: Screens for anaemia, infection, and coagulation issues. Anaemia affects anaesthetic tolerance and recovery; supplementation is arranged pre-operatively where needed.
為什麼要做：評估身體的慢性發炎狀態，並篩查病毒性肝炎。若有肝炎相關發現，我們會在術前與相關科別會診，確認肝臟狀況足以安全承受手術。
Why we do it: Assesses chronic inflammatory status and screens for viral hepatitis. If hepatitis findings are present, we consult the relevant specialty before surgery to confirm the liver is in suitable condition to proceed safely.
🍬 代謝與血糖：手術效益的預測指標
🍬 Metabolic & Glucose Status: Predicting Surgical Benefit
代謝手術對糖尿病有極佳的緩解效果——但要預測這個效果，術前必須全面了解你的血糖控制狀況與胰臟功能。這些數據也決定了圍手術期的血糖管理策略。
Metabolic surgery achieves excellent diabetes remission outcomes — but predicting this benefit requires a comprehensive pre-operative picture of your glycaemic control and pancreatic function. These findings also determine peri-operative glucose management.
為什麼要做：了解術前的血糖控制品質。若血糖控制需要加強，我們會在手術前協助調整，降低術後感染與傷口癒合的風險。
Why we do it: Establishes the quality of pre-operative blood glucose control. If improvement is needed, we support optimisation before surgery to reduce post-operative infection and wound healing risk.
為什麼要做：評估胰臟目前的功能狀況，幫助我們預測代謝手術後糖尿病改善的幅度，並為您設定合理的術後預期。
Why we do it: Evaluates current pancreatic function, helping us predict the degree of metabolic improvement after surgery and set realistic post-operative expectations with you.
🫁 肝臟、腎臟與腹部影像
🫁 Liver, Kidney & Abdominal Imaging
肝臟和腎臟是手術期間藥物代謝、麻醉排除的核心器官。同時，肥胖患者中脂肪肝（非酒精性脂肪性肝病）及膽囊結石的盛行率極高，這兩者都需要在手術前評估清楚。
The liver and kidneys are central to drug metabolism and anaesthetic clearance during surgery. Equally, non-alcoholic fatty liver disease (NAFLD) and gallstones are highly prevalent in patients with obesity — both require pre-operative evaluation.
為什麼要做：評估肝臟的整體健康狀態與合成功能。肝臟是手術期間藥物代謝的核心器官，術前了解其功能有助於麻醉規劃與術後照護，這些數值也作為術後追蹤的基準。
Why we do it: Evaluates overall liver health and synthetic function. The liver is central to drug metabolism during surgery — understanding its function guides anaesthetic planning and post-operative care. These values also serve as baselines for post-operative monitoring.
為什麼要做：評估腎臟功能與尿液狀態，包括早期代謝相關腎損傷的篩查，以及排除術前感染。腎功能狀況影響麻醉藥物選擇與術後的輸液與恢復管理。
Why we do it: Evaluates kidney function and urinary status, including screening for early metabolic-related kidney changes and ruling out pre-operative infection. Renal function informs anaesthetic agent selection and post-operative fluid and recovery management.
超過 70% 的肥胖患者合併有不同程度的脂肪肝。術前超音波不僅評估脂肪肝嚴重程度，也檢查是否有膽囊結石。膽囊結石在減重手術後有更高的機率形成或症狀化（快速體重下降會改變膽汁成分），若術前已有膽石，我們會在手術規劃中一起考量。
Over 70% of patients with obesity have fatty liver of varying severity. Pre-operative ultrasound grades fatty liver and screens for gallstones. Gallstones become more symptomatic after bariatric surgery (rapid weight loss alters bile composition), so pre-existing stones are factored into surgical planning.
⚗️ 血脂、電解質與礦物質
⚗️ Lipids, Electrolytes & Minerals
為什麼要做：血脂是代謝健康的核心指標之一。術前數值作為基準，讓我們在手術後追蹤代謝的實際改善情況。
Why we do it: Lipid levels are a core indicator of metabolic health. Pre-operative values establish a baseline, allowing us to track and document the metabolic improvement that typically follows surgery.
為什麼要做：電解質失衡可能影響心律與手術安全性；礦物質的術前基準值則幫助我們在術後制定個人化的補充計畫，維護長期健康。
Why we do it: Electrolyte imbalances can affect cardiac rhythm and surgical safety; pre-operative mineral baselines guide personalised post-operative supplementation to support long-term health.
為什麼要做：鐵缺乏與維生素 B12 缺乏在肥胖族群中相當常見。術前及早發現並補充，能讓身體在更好的狀態下接受手術，也避免術後因吸收改變而加重缺乏。
Why we do it: Iron deficiency and low vitamin B12 are common in patients with obesity. Early identification and supplementation before surgery helps optimise the body's condition pre-operatively and prevents post-operative worsening due to absorption changes.
🧠 荷爾蒙評估：確認沒有被忽略的體重原因
🧠 Hormonal Evaluation: Ruling Out Unrecognised Contributors to Weight
荷爾蒙失衡有時候是肥胖的原因，而不只是結果。部分患者存在尚未被診斷的荷爾蒙問題，默默影響著體重控制的效果。術前的荷爾蒙評估依個別情況由主治醫師決定，目的是確保我們在最完整的資訊下做出最好的手術規劃。
Hormonal imbalances are sometimes the cause of obesity, not just a consequence. Some patients carry undiagnosed hormonal conditions that quietly affect weight control. The scope of hormonal evaluation is determined by the attending physician based on each individual's profile — ensuring we plan surgery with the most complete picture possible.
為什麼要做：甲狀腺功能直接影響基礎代謝率，功能異常可能導致體重難以控制或影響麻醉安全。視患者個別狀況，我們也可能評估其他與代謝相關的荷爾蒙軸，確保手術在最佳代謝條件下進行。
Why we do it: Thyroid function directly affects basal metabolic rate; abnormalities can make weight control difficult and affect anaesthetic safety. Depending on individual patient profile, we may also assess other metabolically relevant hormonal axes to ensure surgery proceeds under optimal conditions.
為什麼要做：維生素 D 缺乏在肥胖族群中相當普遍，且與骨骼健康密切相關。術前評估骨骼代謝狀態，能讓我們及早安排補充，為術後長期的骨骼與鈣質健康打好基礎。
Why we do it: Vitamin D deficiency is highly prevalent in patients with obesity and closely linked to bone health. Pre-operative assessment of bone metabolism enables early supplementation planning, laying the foundation for long-term skeletal and calcium health after surgery.
🔭 胃鏡：我們在改變你的胃之前，先看清楚它
🔭 Gastroscopy: We Look Before We Operate
代謝手術的核心是改變胃的結構與功能。在此之前，我們必須用胃鏡完整評估你的胃、食道與十二指腸。這不只是慣例，而是臨床上必要的安全把關。
Metabolic surgery fundamentally alters the structure and function of the stomach. Before doing so, we must evaluate your oesophagus, stomach, and duodenum via gastroscopy. This is not merely routine — it is a clinically necessary safety check.
✅ 如果評估發現異常，怎麼辦？
✅ What Happens If Something Is Found?
術前評估若有任何發現，絕大多數不代表手術無法進行。我們的團隊會根據每位患者的個別情況，安排必要的後續處理，待狀況穩定後再評估手術時機。每一個發現，我們都會在門診中與您詳細說明，並一起討論下一步的計畫——您不需要自己解讀報告數字，我們會陪您一起看懂。
The vast majority of pre-operative findings do not mean surgery cannot proceed. Our team addresses each situation based on the individual patient's circumstances, confirming the appropriate timing for surgery once things are stable. Every finding is discussed with you in detail during your clinic visit — you don't need to interpret the numbers on your own; we walk through them together.
我們做這些評估，是為了在手術前充分了解您的身體狀況，讓整個過程在最安全、最有準備的條件下進行。發現問題、處理問題，然後安心手術——這才是術前評估真正的意義。
These evaluations exist so we fully understand your body before surgery — enabling the entire process to proceed under the safest, best-prepared conditions. Find it, address it, then operate with confidence — that is the true purpose of pre-operative evaluation.
🥗 體組成評估與術前飲食衛教
🥗 Body Composition Assessment & Pre-operative Nutritional Counselling
飲食與營養的準備，是術前評估流程中不可或缺的一環。在手術前，我們的營養師團隊將全程陪伴您，從術前的準備、手術期間的照護，到術後長期的飲食調整，提供完整而個人化的指導。
Nutritional preparation is an integral part of the pre-operative evaluation process. Before surgery, our dietitian team will accompany you through every phase — pre-operative preparation, peri-operative care, and long-term post-operative dietary adjustment — providing complete and personalised guidance.
為什麼要做：手術前，我們會測量您的體組成，包括肌肉量、脂肪量與內臟脂肪分佈。這份基準數據讓我們在術後追蹤時，能清楚看到身體成分的實際改變——不只是體重下降，更是脂肪減少、肌肉保留的真實樣貌。
Why we do it: Before surgery, we measure your body composition — including muscle mass, fat mass, and visceral fat distribution. This baseline allows us to track what is actually changing after surgery: not just weight loss on the scale, but the real picture of fat reduction and muscle preservation over time.
為什麼要做：我們的營養師將根據您的評估結果，提供術前、術中與術後三個階段的個人化飲食建議。對於嚴重肥胖或腹部脂肪堆積明顯的患者，術前可能會安排特別的飲食計畫，以縮小肝臟體積、減少腹腔內脂肪的堆積，進而提升手術的安全性與可行性。
Why we do it: Our dietitian provides personalised dietary recommendations across all three phases: pre-operative, peri-operative, and post-operative. For patients with significant obesity or marked central adiposity, a specific pre-operative dietary plan may be arranged to reduce liver volume and intra-abdominal fat — improving surgical safety and feasibility.
💬 術前評估常見問題
💬 Pre-operative Evaluation FAQ
術前評估大概要花多少時間完成？ How long does the complete pre-operative evaluation take?
抽血與尿液檢查通常在一次回診中完成，當天或數日內出報告。胃鏡需另行預約，約 30–60 分鐘。心電圖當天即可完成；心臟超音波視預約情況通常可在 1–2 週內安排。鉈掃描僅在特定情況下安排，需另行預約核醫。整體而言，大多數患者在 2–4 週內可完成全部術前評估。
Blood and urine tests are completed at a single visit with results available within days. Gastroscopy requires a separate appointment (30–60 minutes). EKG is performed the same day; cardiac echo is typically arranged within 1–2 weeks. Thallium scanning is only arranged when indicated. Most patients complete the full pre-operative evaluation within 2–4 weeks.
如果某項檢查結果異常，手術就不能做了嗎？ If a result is abnormal, does surgery have to be cancelled?
幾乎不會。術前評估的目的是「發現問題、解決問題」，而非「找理由不做手術」。多數異常都有對應的處理方案——甲狀腺問題補充藥物、幽門螺旋桿菌先根除、貧血先補鐵、心臟問題先會診調整。真正屬於手術絕對禁忌症的情況極少，且我們會在評估過程中提早識別並與您充分討論。
Almost never. The purpose of pre-operative evaluation is "find and fix," not "find a reason not to operate." Most abnormalities have straightforward management plans — thyroid medication, H. pylori eradication, iron supplementation, cardiology optimisation. Absolute surgical contraindications are rare, and we identify and discuss them fully with you early in the evaluation process.
為什麼術前要做胃鏡？我沒有胃不舒服的感覺。 Why gastroscopy if I have no stomach symptoms?
胃鏡最重要的發現之一——幽門螺旋桿菌感染——通常完全無症狀，卻在縮胃術後顯著增加潰瘍風險。此外，輕度食道炎、早期巴瑞特食道也可能沒有明顯症狀。我們要在改變你的胃之前，先確認它的現況。胃鏡是代謝手術術前不可或缺的安全把關，不是例行公事。
One of gastroscopy's most important findings — H. pylori infection — is typically completely asymptomatic, yet substantially increases ulcer risk after sleeve gastrectomy. Similarly, mild oesophagitis and early Barrett's oesophagus are often symptom-free. We must confirm the current condition of your stomach before altering it. Gastroscopy is an indispensable pre-operative safety check, not a formality.
為什麼術前要評估荷爾蒙？ Why is hormonal evaluation part of the pre-operative workup?
荷爾蒙失衡有時候是肥胖難以控制的原因之一，而不只是結果。術前的荷爾蒙評估由主治醫師根據每位患者的個別狀況決定，目的是確認沒有尚未診斷的因素在默默影響體重，讓手術在最完整的資訊下進行。這是我們為患者多做的一步，也是我們對術前評估負責任的態度。
Hormonal imbalances are sometimes a contributing cause of difficult-to-control weight, not just a consequence. Hormonal evaluation is arranged at the attending physician's discretion based on each patient's individual profile — ensuring no unrecognised factors are quietly affecting weight control, and that surgery proceeds with the most complete information available. This is an extra step we take for our patients, reflecting the standard of care we hold ourselves to.
準備好接受術前評估了嗎？
Ready to Begin Your Pre-operative Evaluation?
林育弘醫師的門診團隊將為您安排完整的術前評估流程，從第一次諮詢到手術日，每一步都有我們陪伴。
Dr. Yu-Hung Lin's clinic team will guide you through the complete pre-operative evaluation process — from initial consultation to surgery day, every step alongside you.