腹腔镜袖状胃切除术后慢性吻合口漏行腹腔镜近端胃切除并食管空肠重建的疗效
Outcomes of laparoscopic proximal gastrectomy with esophagojejunal reconstruction for chronic staple line disruption after laparoscopic sleeve gastrectomy.
作者信息
Thompson Charles E, Ahmad Hira, Lo Menzo Emanuele, Szomstein Samuel, Rosenthal Raul J
机构信息
The Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Department of General & Vascular Surgery, Cleveland Clinic Florida, Weston, Florida.
The Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Department of General & Vascular Surgery, Cleveland Clinic Florida, Weston, Florida.
出版信息
Surg Obes Relat Dis. 2014 May-Jun;10(3):455-9. doi: 10.1016/j.soard.2013.10.008. Epub 2013 Oct 19.
BACKGROUND
Sleeve gastrectomy is now a frequently performed bariatric procedure for severely obese patients and may have the lowest frequency of short-term or long-term complications. The aim of this study is to describe our experience in managing chronic proximal leaks with a proximal gastrectomy and Roux-en-Y esophagojejunostomy (PGEJ).
METHODS
A retrospective review was performed of all patients having proximal chronic staple-line disruptions (CSLD) after undergoing laparoscopic sleeve gastrectomy.
RESULTS
Fifteen patients had proximal CSLD and were treated with PGEJ. There was 1 (6.6%) releak in this group, which resolved with nonoperative treatment. Other postoperative morbidities in this series included partial small bowel obstruction (n = 1) and subhepatic bile collection (n = 1), both of which resolved without operative intervention.
CONCLUSION
PGEJ appears to be a safe and effective procedure for chronic staple-line disruptions after sleeve gastrectomy.
背景
袖状胃切除术目前是一种常用于治疗重度肥胖患者的减肥手术，其短期或长期并发症的发生率可能最低。本研究的目的是描述我们采用近端胃切除术和 Roux-en-Y 食管空肠吻合术（PGEJ）处理慢性近端渗漏的经验。
方法
对所有接受腹腔镜袖状胃切除术后出现近端慢性吻合口漏的患者进行回顾性研究。
结果
15 例患者出现近端慢性吻合口漏并接受了 PGEJ 治疗。该组有 1 例（6.6%）再次发生渗漏，经非手术治疗后痊愈。本系列的其他术后并发症包括部分小肠梗阻（n = 1）和肝下胆汁积聚（n = 1），两者均未经手术干预即自行缓解。
结论
PGEJ 似乎是治疗袖状胃切除术后慢性吻合口漏的一种安全有效的方法。
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