Wang Weu, Wei Po-Li, Lee Yi-Chih, Huang Ming-Te, Chiu Chong-Chi, Lee Wei-Jei
Department of Surgery, En-Chu-Kong Hospital, Taipei, Taiwan.
Obes Surg. 2005 May;15(5):648-54. doi: 10.1381/0960892053923752.
The laparoscopic mini-gastric bypass (MGB) is a modification of Mason's loop gastric bypass, but with a long lesser curvature tube. With weight loss results similar to laparoscopic Roux-en-Y gastric bypass (LRYGBP), the MGB is a simpler operation with a low complication rate. Controversy exists concerning the efficacy and side-effects of this procedure. This report presents the technique of laparoscopic MGB and its results in 423 patients.
From October 2001 to October 2004, 423 consecutive patients (87 males and 336 females) underwent laparoscopic MGB (LMGB) for morbid obesity. Mean age was 30.8 years, preoperative mean weight 120.3 kg and mean BMI 44.2 kg/m2.
All procedures were completed laparoscopically. Mean operative time was 130.8 minutes, and mean hospital stay was 5.0 days. 18 minor early complications (4.3%) were encountered, and 7 major complications (1.7%) occurred. Marginal ulcers were noted in 34 patients (8.0%) during follow-up, and anemia was found in 41 patients (9.7%). Mean BMI decreased to 29.2 and 28.4 kg/m2 at 1-year and 2-year follow-up, with mean excess weight loss 69.3% and 72.2%. The Gastrointestinal Quality of Life Index improved significantly 1 year after the operation.
LMGB has a low complication and mortality rate. The learning curve is less steep than for LRYGBP, whereas the efficacy is similar.
腹腔镜迷你胃旁路术（MGB）是对梅森袢式胃旁路术的一种改良，但采用较长的小弯侧肠管。由于其减重效果与腹腔镜Roux-en-Y胃旁路术（LRYGBP）相似，MGB手术操作更简单，并发症发生率低。关于该手术的疗效和副作用存在争议。本报告介绍了腹腔镜MGB技术及其在423例患者中的应用结果。
2001年10月至2004年10月，423例连续性患者（87例男性，336例女性）因病态肥胖接受了腹腔镜MGB（LMGB）手术。平均年龄30.8岁，术前平均体重120.3kg，平均体重指数（BMI）44.2kg/m²。
所有手术均通过腹腔镜完成。平均手术时间为130.8分钟，平均住院时间为5.0天。出现18例轻度早期并发症（4.3%），7例严重并发症（1.7%）。随访期间34例患者（8.0%）出现边缘性溃疡，41例患者（9.7%）出现贫血。在1年和2年随访时，平均BMI分别降至29.2和28.4kg/m²，平均超重减轻率分别为69.3%和72.2%。术后1年胃肠道生活质量指数显著改善。
LMGB并发症和死亡率低。其学习曲线比LRYGBP平缓，而疗效相似。
