[2025 Annual data report on bariatric and metabolic surgery in Guangdong Province]

Objective: To analyze the implementation status of bariatric and metabolic surgery and the provincial resource distribution characteristics in Guangdong Province in 2025. Methods: Descriptive analysis was performed based on the aggregated data of bariatric and metabolic surgeries reported by 39 hospitals in Guangdong Province in 2025. Using the 2024 provincial data as annual control, we analyzed the total surgical volume, surgical procedure composition, distribution of performing hospitals, urban distribution, and application of novel procedures, with comparative analysis combined with external data (national, Shanghai, and international public databases). External reference materials included the 2024 Annual Report of China Obesity and Metabolic Surgery Database, the 2024 Annual Report of Greater China Bariatric and Metabolic Surgery Database, the Analysis of Quality Control Data of Bariatric and Metabolic Surgery in Shanghai from 2012 to 2023, the global registry report of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), and public data released by the American Society for Metabolic and Bariatric Surgery (ASMBS)/Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). National and Shanghai data were used for horizontal regional comparison, while US data served as a reference for international industry trends. Results: A total of 1611 bariatric and metabolic surgeries were completed in Guangdong Province in 2025, representing an 18.3% increase compared with 1362 cases in 2024; the number of hospitals performing such surgeries rose from 22 to 39. Procedure composition: conventional laparoscopic sleeve gastrectomy (SG) accounted for 1,086 cases (67.4%); Roux-en-Y gastric bypass (RYGB) for 142 cases (8.8%); sleeve gastrectomy with transit bipartition (SG-TB) for 82 cases (5.1%); single-port SG for 87 cases (5.4%); one-anastomosis gastric bypass (OAGB) for 61 cases (3.8%); revisional bariatric surgery for 59 cases (3.7%); bypass stent for 73 cases (4.5%), and robot-assisted SG for 4 cases (0.2%). No cases of hydrogel balloon therapy or endoscopic sleeve gastroplasty (ESG) were reported. The top 10 hospitals ranked by surgical volume in Guangdong Province in 2025 showed an obvious hierarchical distribution. The cumulative volume proportions of the top 3, top 5 and top 10 hospitals reached 71.8%, 81.8% and 90.6%, respectively. In terms of urban distribution, Guangzhou, Shenzhen and Zhongshan contributed 95.8% (1543 cases) of the provincial total. The total number of bariatric surgeries nationwide in China reached 32 342 in 2024, while Shanghai recorded 1430 cases in 2023. Sleeve gastrectomy (SG) accounted for 75.6% of all national procedures in 2024 versus 87.9% in Shanghai in 2023. Roux-en-Y gastric bypass (RYGB) made up 4.7% of national surgeries in 2024 and 7.7% in Shanghai in 2023. There were 1234 one-anastomosis gastric bypass (OAGB) procedures nationwide in 2024, accounting for 3.8%. In the United States, 4587 ESG procedures and 1461 intragastric balloon placements were performed in 2023. Conclusion: The annual volume of bariatric and metabolic surgeries in Guangdong Province maintained an upward trend in 2025, with SG remaining the predominant procedure; however, the distribution of surgeries was highly concentrated by hospital and city. Compared with published national and Shanghai data, Guangdong Province recorded a relatively high surgical volume nationwide and featured a more diverse procedural spectrum. In contrast to international published data, the application volume of novel surgical techniques and new modalities performed in Guangdong Province remained limited at present.