摘要
目的 探讨单吻合口十二指肠回肠转流术作为袖状胃切除术后修正手术的疗效.方法 回顾性分析2020年1月至2023年1月期间山东第一医科大学附属中心医院行单吻合口十二指肠回肠转流术作为袖状胃切除术后修正手术的51例患者的临床资料.结果51例患者在袖状胃切除术后中位47(34,60)个月后进行修正手术.手术均在腹腔镜下完成,未出现中转开腹患者,平均手术时间(122.8±37.4)min,平均术中出血量(24.2±13.5)ml,中位住院时间6(5,6)d.术后1年,患者平均体重从(98.5±16.2)kg 降到(69.8±8.2)kg,BMI从(34.8±3.9)kg/m2降到(24.7±2.1)kg/m2,多余体重减除率从44.0％±11.7％到 97.1％±18.1％,收缩压从(147.6±17.2)mmHg 降到(121.7±7.5)mmHg,舒张压从(84.2±11.5)mmHg 降到(76.0±12.1)mmHg,空腹血糖从(7.1±1.8)mmol/L 降到(4.6±0.4)mmol/L,血清甘油三酯从(1.7±1.1)mmol/L 降到(0.7±0.2)mmol/L,胆固醇从(5.9±0.4)mmol/L 降到(3.9±0.4)mmol/L,低密度脂蛋白从(3.7±0.5)mmol/L降到(2.3±0.2)mmol/L,高密度脂蛋白从(1.1±0.3)mmol/L升高到(1.5±0.7)mmol/L,尿酸从(347.2±90.1)μmol/L降到(270.9±59.6)μmol/L,与术前相比差异均有统计学意义(F=55.9、114.1、158.7、54.3、3.1、59.3、24.2、91.5、1 80.3、8.2、9.8,均 P＜0.05).结论 单吻合口十二指肠回肠转流术作为袖状胃切除术后减重不良或体重反弹患者的修正手术可以显著减轻体重,减少肥胖并发症.
Abstract
Objective To evaluate the short-term efficacy of single-anastomosis duodenoileal bypass as revision surgery following sleeve gastrectomy.Methods The clinical data of 51 patients who underwent single-anastomosis duodenoileal bypass as revision surgery after sleeve gastrectomy in our center from Jan 2020 to Jan 2023 were retrospectively analyzed.Results A total of 51 patients underwent single-anastomosis duodenoileal bypass at 47(34,60)months after sleeve gastrectomy.All patients completed single-anastomosis duodenoileal bypass surgery by laparoscopic approach without conversion to laparotomy.The operative time was(122.8±37.4)min,the intraoperative bleeding volumes was(24.2±13.5)ml,and the length of hospital stay was 6(5,6)d.One year after surgery,the patient's weight decreased from(98.5±16.2)kg to(69.8±8.2)kg,BMI decreased from(34.8±3.9)kg/m2to(24.7±2.1)kg/m2,excess weight loss increased from 44.0％±11.7％to 97.1％±18.1％,systolic blood pressure decreased from(147.6±17.2)mmHg to(121.7±7.5)mmHg,diastolic blood pressure decreased from(84.2±11.5)mmHg to(76.0±12.1)mmHg,fasting blood glucose decreased from(7.1±1.8)mmol/L to(4.6±0.4)mmol/L,triglycerides decreased from(1.7±1.1)mmol/L to(0.7±0.2)mmol/L,cholesterol decreased from(5.9±0.4)mmol/L to(3.9±0.4)mmol/L,LDL decreased from(3.7±0.5)mmol/L to(2.3±0.2)mmol/L,HDL increased from(1.1±0.3)mmol/L to(1.5±0.7)mmol/L,and uric acid decreased from(347.2±90.1)μmol/L to(270.9±59.6)μmol/L,the difference were statistically significant(F=55.9,114.1,158.7,54.3,3.1,59.3,24.2,91.5,180.3,8.2,9.8,all P＜0.05).Conclusion As revision surgery of sleeve gastrectomy,single-anastomosis duodenoileal bypass is feasible and effective,significantly reducing weight and obesity complications.
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