Yan Wei, Sun Zhi-Peng, Lian Dong-Bo, Fan Qing, Li Kai, Liu Chen, Zhang Dong-Dong, Xu Guang-Zhong, Du De-Xiao, Yin Gang, Amin Buhe, Gong Ke, Zhu Bin, Peng Ji-Run, Zhang Neng-Wei
Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2018 Jun;97(22):e10927. doi: 10.1097/MD.0000000000010927.
Bariatric surgery is effective in treating different components of metabolic syndrome including obesity, type 2 diabetes mellitus (T2DM), and hyperlipidemia. But there is no consensus on the ideal biliopancreatic and Roux limb length. This study aimed to explore the effect of biliopancreatic limb and Roux limb lengths during laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures on weight loss and T2DM control.We studied the clinical records of 58 patients with metabolic syndrome, T2DM, and body mass index (BMI) 32 to 50 kg/m who underwent LRYGB in our hospital. The short limb group (Group A) underwent LRYGB with a limb length of 160 to 200 cm (n = 31) and the long limb group (Group B) underwent LRYGB with a limb length of 210 to 240 cm (n = 27) were compared.The occurrence of acute or chronic internal hernia in Group B was higher than that in Group A (P = .026). Twelve months after surgery, patients from the 2 groups were also observed with reduction in BMI, percent excess weight loss (EWL), preoperative FPG, and HbA1c as compared with these indicators before surgery. However, the differences of these indicators between 2 groups were not significant at the time point of before and 3, 6, 12 months after surgery.LRYGB had significant effects on weight loss and diabetes control in obese T2DM patients. However, there was no significant difference in the short term on weight loss and diabetes control in the patients receiving different limb lengths.
减重手术在治疗代谢综合征的不同组成部分方面是有效的,包括肥胖、2型糖尿病(T2DM)和高脂血症。但关于理想的胆胰支和 Roux 袢长度尚无共识。本研究旨在探讨腹腔镜 Roux-en-Y 胃旁路术(LRYGB)中胆胰支和 Roux 袢长度对体重减轻和 T2DM 控制的影响。我们研究了我院 58 例患有代谢综合征、T2DM 且体重指数(BMI)为 32 至 50 kg/m²的患者的临床记录。将短袢组(A 组)31 例行 LRYGB 且袢长度为 160 至 200 cm 与长袢组(B 组)27 例行 LRYGB 且袢长度为 210 至 240 cm 进行比较。B 组急性或慢性内疝的发生率高于 A 组(P = 0.026)。术后 12 个月,观察到两组患者的 BMI、超重减轻百分比(EWL)、术前空腹血糖(FPG)和糖化血红蛋白(HbA1c)与术前这些指标相比均有所降低。然而,在术前以及术后 3、6、12 个月时,两组这些指标的差异均无统计学意义。LRYGB 对肥胖 T2DM 患者的体重减轻和糖尿病控制有显著效果。然而,接受不同袢长度的患者在短期内体重减轻和糖尿病控制方面无显著差异。