中国实用外科杂志

中国实用外科杂志

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腹腔镜胃袖状切除术后修正手术选择及评价

姜舒文，董志勇，陈文辉，王存川   

  1. 暨南大学附属第一医院减重代谢外科，广东广州 510630
  • 出版日期:2020-04-01 发布日期:2020-04-17

  • Online:2020-04-01 Published:2020-04-17

摘要： 我国减重手术例数逐年增加，其中腹腔镜胃袖状切除术（LSG）约占总手术例数的60%，随着手术例数的增加伴随而来的是面临术后严重并发症和复胖问题处理的挑战。对于术前严重并发症或复胖保守治疗无效的病人，修正手术是其治疗的最佳方式。目前，国内外修正手术种类繁多，术后治疗效果不一，如何选择修正手术的方式是保证手术效果使病人获益的关键。LSG术后复胖病人的修正手术要求病人在接受内科治疗及饮食运动治疗无效后，在符合手术适应证的基础上，经过MDT讨论后再选择手术方式。相较其他修正手术方式，现阶段LRYGB是符合各类修正手术指征的手术方式，具体操作中手术方式的选择则因病人病情而异。

关键词: 腹腔镜胃袖状切除术, 胃瘘, 复胖, 肥胖, 修正手术

Abstract: Selection and evaluation of revisional surgery after laparoscopic sleeve gastrectomy        JIANG Shu-wen，DONG Zhi-yong，CHEN Wen-hui，et al. Department of Bariatric and Metabolic Surgery，the First Affiliated Hospital of JINAN University，Guangzhou 510630，China
Corresponding author：WANG Cun-chuan，E-mail：twcc@jnu.edu.cn
Abstract    The number of laparoscopic sleeve gastrectomy in China has been increasing, and as a result, the number of  poor outcome in postoperative weight loss and complications also increase correspondingly. For weight rebounding patients with ineffective conservative treatment，revisional surgery is the best approach to manage weight rebound. There are many kinds of revisional surgery，the effects of revisional surgery are controversial. Therefore，how to choose the revisonal surgery is the key to achieve better effect for postoperative patients. If ineffectvie after undergoing medical treatment and diet and exercise，weight rebounding patients who meet revisional surgical indications may consider revisional surgery with multi-disciplinary team evaluation. Compared with other revisional surgery，LRYGB is in line with all kinds of revisional surgical indications，however, details of  surgical procedures are variable according to the patient’s condition.

Key words: laparoscopic sleeve gastrectomy, gastric fistula, weight regain, obesity, revisional surgery