Obesity Unit, Garcilaso Clinic, Garcilaso, 7, 28010, Madrid, Spain.
World J Surg. 2020 Jun;44(6):1939-1944. doi: 10.1007/s00268-020-05405-5.
Bariatric surgery is often performed not only to lose weight, but also to improve obesity-related comorbidities. A certain metabolic effect of the bariatric techniques has been demonstrated, as the improvement or even remission of comorbidities is patent, before having lost a relevant amount of weight. The autonomic innervation of diverse viscera by the vagus nerve has been hypothesized to participate in it. We aimed to evaluate the ponderal and metabolic impact of the preservation of the hepatic branch of the vagus in type 2 diabetic (T2D) patients undergoing one-anastomosis gastric bypass (OAGB).
We conducted a prospective study on patients with a preoperative diagnosis of morbid obesity and T2D, who underwent an OAGB. Preservation of the hepatic branch of the vagus was carried out in the first 14 patients (Group 1), whereas in another 14 patients it was sectioned. Ponderal and metabolic outcomes were assessed 1 and 2 years after surgery.
The length of the biliary limb was 210 cm in both groups. Postoperative BMI or excess BMI loss was not significantly different between groups. The patients included in Group 1 showed a statistically greater improvement in glycemic and lipid variables.
The preservation of the hepatic branch of the vagus in an OAGB leads to more favorable postoperative glycemic and lipid profiles.
减重手术不仅可以减轻体重，还可以改善与肥胖相关的合并症。已经证明了减重技术的某种代谢作用，因为在减轻了一定量的体重之前，合并症已经得到改善甚至缓解。迷走神经对各种内脏的自主神经支配被假设参与其中。我们旨在评估 2 型糖尿病（T2D）患者在接受单吻合口胃旁路术（OAGB）时保留迷走神经肝支对体重和代谢的影响。
我们对术前诊断为病态肥胖和 T2D 的患者进行了一项前瞻性研究，这些患者接受了 OAGB。在前 14 例患者（第 1 组）中保留了迷走神经肝支，而在另外 14 例患者中则切断了迷走神经肝支。术后 1 年和 2 年评估体重和代谢结果。
两组的胆管支长度均为 210cm。术后 BMI 或超重 BMI 减轻在两组之间无显著差异。第 1 组的患者在血糖和血脂变量方面表现出统计学上更大的改善。
在 OAGB 中保留迷走神经肝支可导致术后血糖和血脂谱更有利。
