腹腔镜胆胰转流术：技术与初步结果。

Laparoscopic biliopancreatic diversion: technique and initial results.

作者信息

Paiva Dyker, Bernardes Lucinéia, Suretti Lívio

机构信息

Centro Mineiro de Cirurgia Avançada, Belo Horizonte, MG, Brasil.

出版信息

Obes Surg. 2002 Jun;12(3):358-61. doi: 10.1381/096089202321087869.

DOI:10.1381/096089202321087869

PMID:12082887

Abstract

BACKGROUND

Biliopancreatic diversion (BPD) is an efficient method for treating morbid obesity. We present the BPD technique by laparoscopy and the 1st year follow-up.

METHODS

From July 2000 to April 2001, 40 patients underwent laparoscopic BPD (29 women, 11 men), with average age 39 (17-60). Average BMI was 43.6 kg/m2 (38-65). All operations were completed successfuly by laparoscopy. The technique followed strictly the operation of Scopinaro. 7 of these patients had removal of an adjustable gastric band and were converted to BPD. All underwent cholecystectomy.

RESULTS

Mean loss of initial excess weight at 3, 6 and 10 months was approximately 30%, 50% and 90%. Mortality was 2.5% (1 patient) due to massive pulmonary embolism. Average operating time was 210 minutes (130-480), and average hospital stay was 4.3 days (3-21). There were 5 postoperative complications (12.5%): 2 pulmonary emboli, 2 GI bleeding from the staple-line, and 1 fistula. There have been 5 late complications (12.5%): 3 cases of diarrhea, 2 elevated PTH with normal calcium, and hypothyroidism that was difficult to control.

CONCLUSION

BPD may be performed by laparoscopy without changes in the original technique or in the early results.

摘要

背景

胆胰转流术（BPD）是治疗病态肥胖的一种有效方法。我们介绍腹腔镜下BPD技术及第一年随访情况。

方法

2000年7月至2001年4月，40例患者接受了腹腔镜BPD手术（29例女性，11例男性），平均年龄39岁（17 - 60岁）。平均体重指数（BMI）为43.6 kg/m²（38 - 65）。所有手术均通过腹腔镜成功完成。该技术严格遵循斯科皮纳罗手术操作。其中7例患者移除了可调节胃束带并转为BPD手术。所有患者均接受了胆囊切除术。

结果

术后3个月、6个月和10个月时，初始超重体重的平均减轻幅度分别约为30%、50%和90%。死亡率为2.5%（1例患者），死于大面积肺栓塞。平均手术时间为210分钟（130 - 480分钟），平均住院时间为4.3天（3 - 21天）。术后有5例并发症（12.5%）：2例肺栓塞、2例吻合口处胃肠道出血和1例瘘管。有5例晚期并发症（12.5%）：3例腹泻、2例甲状旁腺激素升高但血钙正常以及难以控制的甲状腺功能减退。