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腹腔镜治疗Roux-en-Y胃旁路术后胃-胃瘘——两例报告

Laparoscopic treatment of a gastro-gastric fistula after Roux-en-Y gastric bypass-report of two cases.

作者信息

Gaspar Joana Raquel Rodrigues, Marques Paula, Mesquita Isabel, Marcos Mário, Santos Jorge, Nogueira Carlos

机构信息

General Surgery, Department of Surgery, Centro Hospitalar e Universitário do Porto (CHUP), Oporto, Portugal.

出版信息

J Surg Case Rep. 2020 Dec 12;2020(12):rjaa478. doi: 10.1093/jscr/rjaa478. eCollection 2020 Dec.

DOI:10.1093/jscr/rjaa478
PMID:33343864
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7732258/
Abstract

The most frequently performed bariatric surgery is the laparoscopic Roux-en-Y gastric bypass (LRYGB). An uncommon complication of LRYGB is gastro-gastric fistula (GGF). Possible causes of GGF include incomplete transection of the stomach during the initial surgery, staple-line leaks in the post-operative period and marginal ulcers. The optimal management of GGF is still under debate, with medical, endoscopic and surgical treatment modalities available. The authors present two cases of a GGF successfully managed with a laparoscopic surgical approach, after failed medical and endoscopic treatment.

摘要

最常实施的减肥手术是腹腔镜Roux-en-Y胃旁路术（LRYGB）。LRYGB一种不常见的并发症是胃-胃瘘（GGF）。GGF的可能原因包括初次手术时胃切断不完全、术后吻合口漏以及边缘溃疡。GGF的最佳治疗方法仍存在争议，有药物、内镜和手术等治疗方式。在药物和内镜治疗失败后，作者介绍了两例通过腹腔镜手术方法成功治疗GGF的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/c33d7deb54b0/rjaa478f10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/7b2144645dfb/rjaa478f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/d7b630bf022c/rjaa478f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/3cdab9579c8d/rjaa478f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/00ed37715f74/rjaa478f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/9ddcfe6ddae2/rjaa478f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/820e787988a1/rjaa478f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/0ff9a95789a9/rjaa478f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/7b61b3350df4/rjaa478f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/e9b66a0f516d/rjaa478f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/c33d7deb54b0/rjaa478f10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/7b2144645dfb/rjaa478f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/d7b630bf022c/rjaa478f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/3cdab9579c8d/rjaa478f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/00ed37715f74/rjaa478f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/9ddcfe6ddae2/rjaa478f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/820e787988a1/rjaa478f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/0ff9a95789a9/rjaa478f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/7b61b3350df4/rjaa478f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/e9b66a0f516d/rjaa478f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d3/7732258/c33d7deb54b0/rjaa478f10.jpg

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本文引用的文献

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Obes Surg. 2018 Apr;28(4):939-944. doi: 10.1007/s11695-017-2949-2.
3
Successful laparoscopic repair of gastro-gastric fistula following Roux-en-Y gastric bypass at Harlem Community Hospital.
J Surg Case Rep. 2017 Jul 13;2017(7):rjx134. doi: 10.1093/jscr/rjx134. eCollection 2017 Jul.
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Surgical management of gastrogastric fistula.胃胃瘘的外科治疗
Surg Obes Relat Dis. 2015 Nov-Dec;11(6):1227-32. doi: 10.1016/j.soard.2015.03.004. Epub 2015 Mar 12.
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Gastrogastric fistulae following gastric bypass surgery-clinical recognition and treatment.胃旁路手术后的胃胃瘘——临床识别与治疗
Curr Gastroenterol Rep. 2014 Sep;16(9):405. doi: 10.1007/s11894-014-0405-1.
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Surg Endosc. 2009 Nov;23(11):2591-5. doi: 10.1007/s00464-009-0465-8. Epub 2009 May 22.
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