文章摘要

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

作者: 1周程, 1龚昭, 2闵凯, 1曾志武, 1杨光耀, 1夏辉, 3Wojciech Konrad Karcz
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: 闵凯 Email: 843808346@qq.com
DOI: 10.3978/.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。
关键词： 肥胖症/ 外科学 减肥手术/ 方法 胃切除术 十二指肠回肠Ω 转位

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

Authors: 1ZHOU Cheng, 1GONG Zhao, 2MIN Kai, 1ZENG Zhiwu, 1YANG Guangyao, 1XIA Hui, 3Wojciech Konrad Karcz
1 Department of Hepatobililary Surgery, Wuhan No.1 Hospital, Wuhan, 430022, Ch
2 Department of Gastrointestinal Surgery, Wuhan No.1 Hospital, Wuhan, 430022, China
3 Department of Surgery, Division Metabolic and Obesity Surgery, Schleswig-Holstein University Clinic, Campus Lübeck, 23538, Germany

CorrespondingAuthor:MIN Kai Email: 843808346@qq.com

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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