腹腔镜Roux-en-Y胃旁路术治疗垂直束带胃成形术后严重胃食管反流
Laparoscopic Roux-en-Y gastric bypass for severe gastroesophageal reflux after vertical banded gastroplasty.
作者信息
Bloomberg Richard D, Urbach David R
机构信息
Minimally Invasive Surgery Program, Toronto Western Hospital, Department of Surgery, University of Toronto, Toronto, ON, Canada.
出版信息
Obes Surg. 2002 Jun;12(3):408-11. doi: 10.1381/096089202321088264.
BACKGROUND
Vertical banded gastroplasty (VBG) is sometimes associated with complications such as pouch obstruction, dilatation, and gastroesophageal reflux. This occasionally requires surgical revision, in many cases to a Roux-en-Y gastric bypass (RYGBP).
CASE REPORT
A 47-year-old woman with severe obesity developed severe symptoms of stenosis of the pouch outlet and gastroesophageal reflux 15 years after VBG. Laparoscopic conversion to a RYGBP was performed. At 9-month follow-up, she lost an additional 32 kg and had complete resolution of her reflux.
CONCLUSION
In this patient, laparoscopic re-operative RYGBP produced additional weight loss, and improved gastroesophageal reflux that occurred many years after having a VBG. Laparoscopic conversion of a VBG to RYGBP is feasible, and may confer the benefits of other minimally invasive abdominal procedures to this high-risk patient group.
背景
垂直束带胃成形术（VBG）有时会伴有诸如胃囊梗阻、扩张及胃食管反流等并发症。这偶尔需要进行手术修正，在许多情况下需转为 Roux-en-Y 胃旁路术（RYGBP）。
病例报告
一名 47 岁的重度肥胖女性在 VBG 术后 15 年出现胃囊出口狭窄及胃食管反流的严重症状。遂行腹腔镜下转为 RYGBP 手术。在 9 个月的随访中，她又减重 32 千克，且反流症状完全缓解。
结论
对于该患者，腹腔镜再次手术行 RYGBP 实现了额外的体重减轻，并改善了 VBG 术后多年出现的胃食管反流。将 VBG 腹腔镜转为 RYGBP 是可行的，且可能为这一高危患者群体带来其他微创腹部手术的益处。
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