Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
Department of Pathology, Inonu University, Malatya, Turkey.
Obes Res Clin Pract. 2021 May-Jun;15(3):297-299. doi: 10.1016/j.orcp.2021.03.009. Epub 2021 Mar 23.
Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric surgery in recent years, and some modifications have emerged to improve its efficacy. Melissas has described SG plus jejuno-ileal bypass (JIB), which has reported good results in a few studies. We performed this procedure in 21 cases and in one case, we observed acute liver failure (ALF) that has not been reported before.
A 38-year-old female (BMI: 56.1 kg/m) underwent laparoscopic SG plus JIB. There was no sign of diarrhea, malnutrition or liver failure for eight months and her BMI was 43.0 kg/m. At the 9th month, she was hospitalized for abdominal pain, jaundice and ALF. The patient was treated by plasmapheresis and molecular absorptive recirculation system. She was planned to undergo liver transplantation but died of multiorgan failure on the 40th day of hospitalization.
ALF can be observed following SG plus JIB. JIB reversal before compromising liver functions should be taken into consideration.
腹腔镜袖状胃切除术（LSG）是近年来最常施行的减重手术之一，为了提高疗效，出现了一些改良术式。Melissas 描述了胃旁路术联合空回肠旁路术（JIB），该术式在少数研究中取得了良好的效果。我们对 21 例患者施行该术式，其中 1 例患者术后发生了急性肝衰竭（ALF），这是此前尚未报道过的并发症。
一名 38 岁女性（BMI：56.1kg/m）接受了腹腔镜袖状胃切除术联合 JIB。术后 8 个月内，患者没有出现腹泻、营养不良或肝衰竭的迹象，其 BMI 为 43.0kg/m。第 9 个月，患者因腹痛、黄疸和 ALF 住院。患者接受了血浆置换和分子吸附再循环系统治疗。她原本计划接受肝移植，但在住院第 40 天死于多器官衰竭。
SG 联合 JIB 后可能会发生 ALF。在出现肝功能损害之前，应考虑进行 JIB 反转。
