Park Ji Yeon, Kim Yong Jin
Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Ann Surg Treat Res. 2014 Oct;87(4):217-21. doi: 10.4174/astr.2014.87.4.217. Epub 2014 Sep 25.
Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures around the world. Although RYGB is the gold standard for treating morbid obesity, it carries the risk of rare but serious long-term complications from malnutrition. We report a case of laparoscopic reversal of RYGB. A female patient reported prolonged incapacitating postprandial pain that consequently made her avoid proper oral intake. Therefore, she became seriously malnourished at 30 months after RYGB and requested reversal of RYGB into normal anatomy. The operation was successfully performed via laparoscopy. Operating time was 120 minutes, and intraoperative blood loss was 20 mL. The patient was discharged without any complications directly related to surgical procedures, although her hospital stay was prolonged by the treatment of asymptomatic septicemia of unknown origin. Laparoscopic reversal of RYGB into normal anatomy is technically feasible and might be performed safely after thorough preoperative evaluation in carefully selected patients.
Roux-en-Y胃旁路术（RYGB）是全球最常用的减肥手术之一。尽管RYGB是治疗病态肥胖的金标准，但它存在因营养不良导致罕见但严重的长期并发症的风险。我们报告一例腹腔镜下RYGB逆转术。一名女性患者自述餐后疼痛持续时间长且使人衰弱，因此她避免了正常的经口摄入。因此，在RYGB术后30个月时她严重营养不良，并要求将RYGB逆转至正常解剖结构。该手术通过腹腔镜成功完成。手术时间为120分钟，术中失血20毫升。患者出院时没有与手术操作直接相关的任何并发症，尽管她因不明原因的无症状败血症的治疗而延长了住院时间。在精心挑选的患者中，经过全面的术前评估后，腹腔镜下将RYGB逆转至正常解剖结构在技术上是可行的，并且可能安全进行。
