Grgić Tihomir, Diklić Davorin, Grgić Dora, Nikolić Marko, Kulis Tomislav, Bekavac-Beslin Miroslav
Department of Surgery, Zabok General Hospital, Zabok, Croatia.
Acta Clin Croat. 2011 Jun;50(2):239-43.
Morbid obesity is currently one of the leading problems worldwide. More than 1 of 5 adults in Croatia are considered obese, with a body mass index (BMI) higher than 30 kg/ m(2), with no sex differences. Indications for bariatric surgery are BMI >40 kg/m(2) or BMI >35 kg/m(2) with comorbidities. Bariatric procedures are divided into restrictive, malabsorptive, and combined procedures. The Roux-en-Y gastric bypass is a combined bariatric procedure, already being accepted as the standard one in the USA and gaining ground in Europe as well. A 47-year-old woman with BMI of 48.2 kg/m(2) (105.5 kg) was hospitalized at our department. Her increasing attempts to lose weight using conservative methods showed no success. She also suffered from glucose intolerance, gastritis, chronic obstructive pulmonary disease, hypertension and depression as comorbidities. Based on our experience in bariatric surgery (gastric banding, sleeve gastrectomy, duodenal switch), we decided for the first time in our hospital to perform laparoscopic Roux-en-Y gastric bypass. The patient was released on the fifth postoperative day with BMI of 40.56 kg/m(2) (100 kg body weight), excess weight loss 12.5%. One month after the procedure, her BMI was 38.54 kg/m(2), excess weight loss 23.92% (body weight 95 kg).
病态肥胖目前是全球主要问题之一。克罗地亚超过五分之一的成年人被认为肥胖，体重指数（BMI）高于30kg/m²，且无性别差异。减肥手术的指征是BMI>40kg/m²或BMI>35kg/m²且伴有合并症。减肥手术分为限制性、吸收不良性和联合性手术。Roux-en-Y胃旁路术是一种联合减肥手术，在美国已被视为标准术式，在欧洲也逐渐流行。一名47岁女性，BMI为48.2kg/m²（体重105.5kg），入住我院。她越来越多地尝试采用保守方法减肥，但均未成功。她还患有糖耐量异常、胃炎、慢性阻塞性肺疾病、高血压和抑郁症等合并症。基于我们在减肥手术（胃束带术、袖状胃切除术、十二指肠转位术）方面的经验，我院首次决定为该患者实施腹腔镜Roux-en-Y胃旁路术。患者术后第五天出院，BMI为40.56kg/m²（体重100kg），超重减轻12.5%。术后一个月，她的BMI为38.54kg/m²，超重减轻23.92%（体重95kg）。
