中国实用外科杂志

中国实用外科杂志

• 论蓍 • 上一篇    下一篇

单吻合口胃旁路术治疗病态肥胖症56例疗效分析

刘    洋，李梦伊，张    萌，刘    佳，边识博，田沛荣，金    岚，张    鹏，张忠涛   

  1. 首都医科大学附属北京友谊医院普通外科中心     国家消化系统疾病临床医学研究中心，北京 100050
  • 出版日期:2020-04-01 发布日期:2020-04-17

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

摘要： 目的    探讨单吻合口胃旁路术（OAGB）治疗病态肥胖症及其相关合并症的有效性与安全性。方法    回顾性分析2018年9月至2019年10月首都医科大学附属北京友谊医院普通外科中心实施OAGB的56例肥胖病人的临床资料。结果    56例均顺利完成手术，无中转开腹病例。手术时间为78~262（131.7±30.6）min，术中失血量为20~200（45.2±50.9）mL，术后住院时间为3~7（4.4±1.1）d，每台手术所需钉仓数为5~8（6.7±0.7）个。术后6周内12例（21.4%）发生并发症，其中Clavien-Dindo分级Ⅰ级7例、Ⅱ级4例、Ⅲb级1例。术后3、6、12个月的总体重减少百分比（%TWL）分别为20.0%、26.5%及33.5%。完成术后12个月随访的25例病人中，2型糖尿病、高血压病、高脂血症及高尿酸血症的缓解率分别为100%、83.3%、91.7%及44.4%。结论    OAGB治疗病态肥胖症及其相关合并症安全且有效，术后随访应密切关注胆汁反流和营养不良风险。

关键词: 病态肥胖症, 单吻合口胃旁路术, 临床疗效, 胆汁反流, 营养不良

Abstract: Clinical outcome of one anastomosis gastric bypass in the treatment of morbid obesity：An analysis of 56 cases           LIU Yang，LI Meng-yi，ZHANG Meng，et al. Department of General Surgery，Beijing Friendship Hospital，Capital Medical University & National Clinical Research Center for Digestive Diseases，Beijing 100050，China
Corresponding authors：ZHANG Peng，E-mail：zhangpg@yahoo.com; ZHANG Zhong-tao，E-mail：zhangzht@ccmu.edu.cn
Abstract    Objective    To evaluate the efficacy and safety of one anastomosis gastric bypass（OAGB）as a treatment modality for morbid obesity. Methods    The clinical data of 56 patients who underwent OAGB in Department of General Surgery，Beijing Friendship Hospital of Capital Medical University from September 2018 to October 2019 were collected and analyzed retrospectively. Results    All operations were successfully performed by laparoscopy without intraoperative conversion to open procedures. The mean operative duration was 78-262（131.7±30.6）min; the mean intraoperative blood loss was 20-200（45.2±50.9）mL; the mean postoperative hospital stay was 3-7（4.4±1.1）d，and the mean number of stapler cartridges needed for each operation was 5-8(6.7±0.7). There were 12 cases （21.4%） with early postoperative complications，including 7 cases of grade Ⅰ，4 cases of gradeⅡ and 1 case of grade Ⅲb. The percentage of total weight loss was 20.0%，26.5% and 33.5% in 3 months，6 months and 12 months after operation respectively. The remission rate of type 2 diabetes，hypertension，hyperlipidemia and hyperuricemia were 100%，83.3%，91.7% and 44.4% at 12 months follow-up respectively. Conclusion    OAGB is an effective procedure for treating morbid obesity and related metabolic disorders. However，bile reflux and malnutrition risk need to be monitored during follow-up period.

Key words: morbid obesity, one anastomosis gastric bypass, clinical outcome, bile reflux, malnutrition