Del Genio Gianmattia, Gagner Michel, Cuenca-Abente Federico, Nocca David, Biertho Laurent, Del Genio Federica, Assalia Ahmad, Del Genio Alberto
Foregut and Obesity Pathophysiology Study Center, Department of Surgery, University of Naples II, via Pansini 5, Naples, 80131, Italy.
Obes Surg. 2008 Oct;18(10):1263-7. doi: 10.1007/s11695-008-9602-z. Epub 2008 Jun 18.
One limit of the Roux-en-Y gastric bypass (GBP) is the preclusion of exploring the bypassed stomach with conventional endoscopy and radiological studies. In this study, we explored the feasibility, safety, and weight progression of a new bariatric procedure that eliminates this inconvenience.
Eleven 40- to 50-kg Yorkshire pigs underwent laparoscopic sleeve gastrectomy and Roux-en-Y duodeno-jejunal bypass (SG-DJBP). Weight was monitored at postoperative days 15 and 30 and after 3 months; weight progression was compared with an identical group that underwent a sham procedure or GBP. At autopsy, surgical site was evaluated at microscopic and macroscopic level.
Mean operating time was 66 +/- 5.76 min. All the survivors tolerated the procedure well, except one subject that experienced a gastric leak from the stapler line. The SG-DJBP had a had significantly slower weight gains than the sham group (P = 0.005). The absence of histological abnormalities in the duodenal wall was confirmed at autopsy.
SG-DJBP is feasible and produces effects of weight progression comparable to those of GBP. Being a combination of previously standardized procedures, we are confident to propose this procedure as a bariatric alternative in humans. Long-term follow-up will be required to establish the efficacy on weight loss in humans.
Roux-en-Y胃旁路术（GBP）的一个局限性在于无法通过传统内镜检查和放射学研究对旷置的胃进行探查。在本研究中，我们探索了一种新的减肥手术的可行性、安全性和体重变化情况，该手术消除了这一不便之处。
11只体重40至50千克的约克夏猪接受了腹腔镜袖状胃切除术和Roux-en-Y十二指肠空肠旁路术（SG-DJBP）。在术后第15天、30天以及3个月后监测体重；将体重变化情况与接受假手术或GBP的相同组进行比较。尸检时，从微观和宏观层面评估手术部位。
平均手术时间为66±5.76分钟。除1只猪在吻合器缝线处出现胃漏外，所有存活猪对该手术耐受性良好。SG-DJBP组的体重增加明显慢于假手术组（P = 0.005）。尸检证实十二指肠壁无组织学异常。
SG-DJBP是可行的，其体重变化效果与GBP相当。作为先前标准化手术的组合，我们有信心将该手术作为人类减肥的一种替代方法。需要进行长期随访以确定其对人类体重减轻的疗效。
