胃食管反流病与肥胖患者。
Gastroesophageal Reflux Disease and the Patient with Obesity.
机构信息
Department of Surgery, Stanford University School of Medicine, 3800 Reservoir Rd NW, Washington, DC 20007, USA. Electronic address: https://twitter.com/yewandealimiMD.
Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680H, Stanford, CA 94305-5655, USA.
出版信息
Gastroenterol Clin North Am. 2021 Dec;50(4):859-870. doi: 10.1016/j.gtc.2021.08.010. Epub 2021 Oct 6.
Patients with obesity who present with gastroesophageal reflux disease (GERD) require a nuanced approach. Those with lower body mass index (BMI) (less than 33) can be counseled on weight loss, and if successful may be approached with laparoscopic fundoplication. Those who are unable to achieve weight loss or those who present with a BMI greater than or equal to 35 should proceed with laparoscopic Roux-en-Y gastric bypass (LRYGB). Conversion to LRYGB from sleeve gastrectomy is a safe and effective way to manage GERD after sleeve gastrectomy.
肥胖症伴胃食管反流病（GERD）的患者需要采取细致的治疗方法。对于体重指数（BMI）较低（低于 33）的患者，可以进行减肥咨询，成功减肥后可采用腹腔镜胃底折叠术（laparoscopic fundoplication）治疗。对于那些无法减轻体重或 BMI 大于或等于 35 的患者，应进行腹腔镜 Roux-en-Y 胃旁路手术（LRYGB）。对于胃袖状切除术（sleeve gastrectomy）后出现 GERD 的患者，将其转为 LRYGB 是一种安全有效的治疗方法。
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