Abstract: The value and challenges of sleeve gastrectomy with transit bipartition        ZHU Xiao-cheng, YAO Li-bin. Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China
Corresponding author: ZHU Xiao-cheng, E-mail:zhuxccf@163.com
Abstract    Sleeve gastrectomy with transit bipartition (SG-TB) operation as a novel metabolic and bariatric surgery (MBS) has been increasingly performed in China and abroad in recent years. SG-TB can significantly reduce the weight of obese patients with diabetes, and improve glucose metabolism and other obesity-related complications, without increasing the risk of postoperative adverse events. SG-TB has low technical difficulty and is well-accepted by doctors and patients. Moreover, SG-TB has reversibility and modifiability, which can be reversed or modified according to the patient’s condition. It can also avoid complications related to remnant stomach and blind loop, making it a safe and effective MBS procedure. However, SG-TB still lacks large-scale, multicenter, randomized controlled clinical evidence, and its long-term outcomes and complications are unclear. In addition, issues such as malnutrition, bile reflux, and anastomosis design of SG-TB still need further research and discussion.

Key words: obesity, type 2 diabetes mellitus, metabolic and bariatric surgery, sleeve gastrectomy, transit bipartition

摘要： 胃袖状切除术联合双通道术（SG-TB）作为一种新型减重与代谢手术（MBS），近年来在国内外开展逐渐增多。SG-TB可以显著降低肥胖合并糖尿病病人的体重、改善糖代谢和其他肥胖相关并发症，且不增加术后不良事件的风险。SG-TB操作技术难度较低，医生和病人均易接受，且具有可逆性和可修正性，可以根据病人的情况进行逆转或修正，还可避免残胃和盲袢的相关并发症，是一种安全有效的MBS术式。目前尚缺乏SG-TB的大规模、多中心、随机对照的临床循证证据，其长期效果和远期并发症尚不明确。此外，SG-TB的营养不良、胆汁反流及吻合口设计等问题仍需要进一步开展相关的研究和探讨。

关键词: 肥胖, 2型糖尿病, 减重与代谢手术, 胃袖状切除术, 双通道术