临床研究(Clinical Research)

袖状胃切除术十联合二指肠回肠Ω 转位:一种新型的复合型减肥外科术式

Published at: 2015年第24卷第12期

周程 1 , 龚昭 1 , 闵凯 2 , 曾志武 1 , 杨光耀 1 , 夏辉 1 , Wojciech Konrad Karcz 3
1 湖北省武汉市第一医院肝胆外科,湖北 武汉430022
2 湖北省武汉市第一医院胃肠外科,湖北 武汉430022
3 德国吕贝克大学医学院 代谢及肥胖外科,吕贝克 23538
通讯作者 凯 闵 Email: 843808346@qq.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.12.019
基金:
湖北省武汉市人力资源与社会保障局2012 年度留学人员科技活动择优资助项目 2012(258)
湖北省武汉市科技局对外科技合作与交流计划资助项目 201171034321

摘要

目的:探讨分阶段实施腹腔镜袖状胃切除术(LSG)及十二指肠回肠Ω 转位术(DIOS)对于外科治疗 病态肥胖症的可行性和意义。 方法:对2012 年收治的病态肥胖合并合并2 型糖尿病、高血脂女性患者1 例,分阶段于同年4 月13 日 实施LSG,随访11 个月后于2013 年3 月12 日实施DIOS,分析其手术前后肥胖与相关指标的变化及 并发症情况。 结果:患者LSG 术前、DIOS 术前、随访2 年,体质量指数(47.6、42.3、31.0 kg/m2)、体质量(140、 125、92 kg)、糖化血红蛋白水平(6.3%、5.7%、5.0%),血甘油三酯水平(2.54、1.87、1.26 g/L),总 胆固醇水平(2.42、1.89、1.68 g/L)均呈下降表现,且随访2 年时患者完全脱离降糖药物治疗。围术 期及术后2 年内,未发现吻合口瘘、营养不良、脱发、倾倒综合征及胆汁反流等近、远期并发症。 结论:LSG 联合DIOS 具备分阶式减肥组合术式特性,有望在临床上开展。


Sleeve gastrectomy associated with duodeno-ileal omega switch: a new type of combined bariatric operation

Abstract

Objective: To investigate the possibility and applicability of the staged operation of laparoscopic sleeve gastrectomy (LSG) and duodeno-ileal omega switch (DIOS) in surgical treatment of morbid obesity. Methods: A female morbidly obese patient with concomitant type 2 diabetes and hyperlipidemia admitted in 2012 underwent staged operation of LSG on 13th April of the same year, and then DIOS on 12th March 2013 after 11-month follow-up. The changes in obesity indexes and other relevant parameters of the patient before and after operation as well as the complications were analyzed. Results: The relevant data of the patient at pre-LSG, pre-DIOS and 2 years after DIOS, indicated the body mass index (47.6, 42.3, and 31.0 kg/m2), body weight (140, 125, and 92 kg), glycosylated hemoglobin (6.3%, 5.7%, and 5.0%), blood triglyceride (2.54, 1.87 and 1.26 g/L) and total cholesterol (2.42, 1.89 and 1.68 g/L) all showed a decreasing pattern, moreover, the patient completely eliminated dependency on glucose lowering drugs at two years after operation. During perioperative and 2-year postoperative period, no short- or long-term complications such as anastomotic leakage, malnutrition, alopecia, dump syndrome or biliary reflux occurred. Conclusion: LSG associated with DIOS owns the features of stepwise bariatric operation, and seems to be promising in clinical practice.


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引用

引用本文: 程 周, 昭 龚, 凯 闵, 志武 曾, 光耀 杨, 辉 夏, Karcz Wojciech Konrad . 袖状胃切除术十联合二指肠回肠Ω 转位:一种新型的复合型减肥外科术式[J]. 中国普通外科杂志, 2015, 24(12): 1737-1741.
Cite this article as: ZHOU Cheng, GONG Zhao, MIN Kai, ZENG Zhiwu, YANG Guangyao, XIA Hui, Wojciech Konrad Karcz . Sleeve gastrectomy associated with duodeno-ileal omega switch: a new type of combined bariatric operation[J]. Chin J Gen Surg, 2015, 24(12): 1737-1741.