Department of Surgery, Section of Minimally Invasive and BariatricSurgery, Stanford University School of Medicine, Stanford, CA, USA.
J Am Coll Surg. 2011 Feb;212(2):209-14. doi: 10.1016/j.jamcollsurg.2010.09.020. Epub 2010 Dec 22.
Severe obesity remains the leading public health crisis of the industrialized world, with bariatric surgery the only effective and enduring treatment. Poor psychological adjustment has been occasionally reported postoperatively. In addition, evidence suggests that patients can metabolize alcohol differently after gastric bypass.
Preoperatively and at 3 and 6 months postoperatively, 19 Roux-en-Y gastric bypass (RYGB) patients' breath alcohol content (BAC) was measured every 5 minutes after drinking 5 oz red wine to determine peak BAC and time until sober in a case-crossover design preoperatively and at 6 months postoperatively.
Patients reported symptoms experienced when intoxicated and answered a questionnaire of drinking habits. The peak BAC in patients after RYGB was considerably higher at 3 months (0.059%) and 6 months (0.088%) postoperatively than matched preoperative levels (0.024%). Patients also took considerably more time to return to sober at 3 months (61 minutes) and 6 months (88 minutes) than preoperatively (49 minutes). Postoperative intoxication was associated with lower levels of diaphoresis, flushing, and hyperactivity and higher levels of dizziness, warmth, and double vision. Postoperative patients reported drinking considerably less alcohol, fewer preferred beer, and more preferred wine than before surgery.
This is the first study to match preoperative and postoperative alcohol metabolism in gastric bypass patients. Post-RYGB patients have much higher peak BAC after ingesting alcohol and require more time to become sober. Patients who drink alcohol after gastric bypass surgery should exercise caution.
重度肥胖仍然是工业化世界的主要公共健康危机，减重手术是唯一有效且持久的治疗方法。术后偶尔会报告心理调整不良。此外，有证据表明，患者在胃旁路手术后对酒精的代谢可能不同。
在术前和术后 3 个月和 6 个月，19 例 Roux-en-Y 胃旁路（RYGB）患者在饮用 5 盎司红酒后，每隔 5 分钟测量一次呼气酒精含量（BAC），以确定峰值 BAC 和术后 6 个月清醒时间。在术前和术后 6 个月，采用病例交叉设计。
患者报告了醉酒时的症状，并回答了一份关于饮酒习惯的问卷。RYGB 术后 3 个月（0.059%）和 6 个月（0.088%）的患者峰值 BAC 明显高于术前水平（0.024%）。患者在术后 3 个月（61 分钟）和 6 个月（88 分钟）清醒所需的时间也明显长于术前（49 分钟）。术后醉酒与出汗、脸红和多动减少以及头晕、温暖和复视增加有关。术后患者报告饮酒量明显减少，更喜欢啤酒的人减少，更喜欢葡萄酒的人增加。
这是第一项比较胃旁路患者术前和术后酒精代谢的研究。RYGB 术后患者摄入酒精后 BAC 峰值更高，清醒所需时间更长。胃旁路手术后饮酒的患者应谨慎。
