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腹腔镜与开腹胆胰分流术:前瞻性对照研究。

Laparoscopic versus open biliopancreatic diversion: a prospective comparative study.

机构信息

Department of General Surgery, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.

出版信息

Obes Surg. 2010 Oct;20(10):1348-53. doi: 10.1007/s11695-010-0140-0.

Abstract

BACKGROUND

Bariatric surgery is playing an increasingly important role in our society. The surgical approach should be chosen in consistent with the patients' problem. The purpose of this study was to compare surgical outcomes in patients who underwent laparoscopic Scopinaro's biliopancreatic diversion (BPD) versus open BPD in our institute experience.

METHODS

Eighty patients were enrolled and divided in two groups: laparoscopic group (VL) and open group (OP), with 40 patients in each group during two calendar years 2006-2007. We performed the same technique for both groups using the same staplers for anastomosis, with the same measurements for alimentary and common limbs in both groups. We compared the following variables in the two groups: operative time, intra and early postoperative complications, postoperative pain, consumption of analgesics, recovery of intestinal function, days to removal of NG tube and start of oral intake, hospital stay, and late complication-incisional hernia incidence.

RESULTS

We found statistically significant reduction in favor of laparoscopic group regarding reduction in postoperative pain, consumption of analgesics, incidence of incisional hernia, operative time, and hospital stay-with early removal of NG tube and early oral intake. We did not find any statistically significant difference regarding intra, immediate and early postoperative complications and recovery of intestinal functions.

CONCLUSIONS

Laparoscopic BPD is a safe technique; has good results without affecting the duration of the intervention; and ensures less postoperative pain with rapid functional recovery, less hospital stay, and drastic reduction of incisional hernia incidence.

摘要

背景

减重手术在我们的社会中正发挥着越来越重要的作用。手术方式的选择应与患者的问题相适应。本研究的目的是比较我院采用腹腔镜 Scopinaro 胆胰分流术(BPD)与开腹 BPD 的手术效果。

方法

本研究纳入了 80 名患者,并将其分为两组:腹腔镜组(VL)和开腹组(OP),每组 40 例,在两个连续的年份(2006-2007 年)进行。我们为两组患者采用相同的技术,使用相同的吻合器进行吻合,两组的食物和共同支的测量值相同。我们比较了两组以下变量:手术时间、术中及术后早期并发症、术后疼痛、镇痛药消耗、肠道功能恢复、拔除 NG 管和开始口服摄入的时间、住院时间以及晚期并发症-切口疝发生率。

结果

我们发现腹腔镜组在术后疼痛减轻、镇痛药消耗减少、切口疝发生率、手术时间和住院时间方面具有显著优势,并且 NG 管拔除和早期口服摄入更早。我们没有发现两组之间在术中、即刻和早期术后并发症以及肠道功能恢复方面存在统计学上的显著差异。

结论

腹腔镜 BPD 是一种安全的技术;不会影响干预的持续时间,且具有良好的效果;它能减轻术后疼痛,促进快速功能恢复,缩短住院时间,并显著降低切口疝的发生率。

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