Mittempergher F, Bruni T, Bruni O, Di Betta E, Occelli G, Salerni B
Università degli Studi di Brescia.
Ann Ital Chir. 2002 Mar-Apr;73(2):137-42.
We present our experience in malabsorbitive procedure in bariatric surgery based on Biliopancreatic Diversion (BPD) with transitory gastroplasty. Since 1995 we operated on 74 patients with BPD coupled with gastroplasty which is transitory due to the presence of a band in polidioxanone (PDS). The technique, proposed by Vassallo et al. in 1992, involve the respect of the duodenal bulb (5 centimeter from the pylorous) making an end-to-side duodeno-ileal isoperistaltic anastomosis. The initial excess weight loss was satisfactory (69.8% +/- 11.4% after 1 year) and it kept being stable during all the follow-up (75.2% +/- 6.4% after 5 years). The mortality was absence. We didn't observe ipoalbuminemia, diarrhea or halitosis in any patients. Only 1 patient (1.3%) developed an anastomotic ulcer. After 5 years follow-up we observed 2 cases (12.5%) of chronic hypochromic anemia and 1 case (6.2%) of hypocalcemia. We didn't perform any restorative operation. We consider this technique a good malabsortive procedure able to obtain a satisfactory and stable weight loss, with a low incidence of complications. Moreover it could be applied in patients previously treated by an ineffective gastroplasty.
我们介绍了基于胆胰转流术（BPD）并结合暂时性胃成形术的减重手术中吸收不良手术的经验。自1995年以来，我们对74例患者进行了BPD联合胃成形术，由于聚二氧六环酮（PDS）带的存在，该胃成形术是暂时性的。1992年由瓦萨洛等人提出的该技术，包括保留十二指肠球部（距幽门5厘米），进行端侧十二指肠-回肠等蠕动吻合术。最初的体重减轻情况令人满意（1年后为69.8%±11.4%），并且在整个随访期间保持稳定（5年后为75.2%±6.4%）。无死亡病例。我们在任何患者中均未观察到低白蛋白血症、腹泻或口臭。只有1例患者（1.3%）发生了吻合口溃疡。5年随访后，我们观察到2例（12.5%）慢性低色素性贫血和1例（6.2%）低钙血症。我们未进行任何修复手术。我们认为该技术是一种良好的吸收不良手术，能够实现令人满意且稳定的体重减轻，并发症发生率低。此外，它可应用于先前接受无效胃成形术治疗的患者。
