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中国肥胖患者胆胰转流十二指肠转位术结局的首次研究。

First study on the outcomes of biliopancreatic diversion with duodenal switch in Chinese patients with obesity.

作者信息

Wang Lun, Zhang Zheng, Wang Zeyu, Jiang Tao

机构信息

Department of Bariatric and Metabolic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

Front Surg. 2023 Jan 6;9:934434. doi: 10.3389/fsurg.2022.934434. eCollection 2022.

Abstract

BACKGROUND

Biliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric procedure used in the treatment of obesity and related metabolic disorders. However, to date, the data on BPD-DS among Chinese patients with obesity is completely lacking.

OBJECTIVE

This is the first study to evaluate the safety and efficacy of BPD-DS in the treatment of Chinese patients with obesity.

METHODS

Data from 12 patients undergoing BPD-DS between September 2019 and March 2020 were analyzed retrospectively to evaluate complications, weight loss, comorbidity resolution, and nutritional status.

RESULTS

All patients completed the 1-year follow-up. There was no conversion to laparotomy or death. Mean operative time was 257.08 ± 29.27 min. The median length of stay was 7 days (ranging from 4-38 days). Complications occurred in three patients. The 1-year body mass index was 25.13 ± 4.71 kg/m with a mean excess weight loss of 100.11 ± 33.29% and a mean total weight loss of 43.22 ± 7.71%. Remission was achieved in 100% (7/7 cases) for type 2 diabetes, in 83.3% (10/12 cases) for hypertension, and in 62.5% (5/8 cases) for hyperuricemia. At 1 year after BPD-DS, the prevalence of albumin deficiency was 16.7%, for iron deficiency was 16.7%, and for zinc deficiency was 50%. There were 8.3% of the patients who were anemic. High deficiency rates for vitamins were presented mainly in vitamin A and vitamin E: vitamin A in 58.3% of the patients and vitamin E in 50% of the patients. The prevalence of asymptomatic gallstones increased significantly from 0% preoperatively to 41.7% postoperatively.

CONCLUSION

BPD-DS had excellent weight loss and resolution of comorbidities among Chinese patients with obesity. However, high rates of nutritional deficiencies and complications were found after BPD-DS, especially for vitamin A and vitamin E.

摘要

背景

胆胰转流十二指肠转位术(BPD-DS)是一种用于治疗肥胖症及相关代谢紊乱的减肥手术。然而,迄今为止,中国肥胖患者接受BPD-DS治疗的数据完全缺失。

目的

这是第一项评估BPD-DS治疗中国肥胖患者安全性和有效性的研究。

方法

回顾性分析2019年9月至2020年3月期间12例行BPD-DS手术患者的数据,以评估并发症、体重减轻、合并症缓解情况及营养状况。

结果

所有患者均完成了1年随访。无中转开腹或死亡病例。平均手术时间为257.08±29.27分钟。中位住院时间为7天(4 - 38天)。3例患者出现并发症。1年时体重指数为25.13±4.71kg/m²,平均超重减轻率为100.11±33.29%,平均总体重减轻率为43.22±7.71%。2型糖尿病缓解率达100%(7/7例),高血压缓解率为83.3%(10/12例),高尿酸血症缓解率为62.5%(5/8例)。BPD-DS术后1年,白蛋白缺乏患病率为16.7%,铁缺乏患病率为16.7%,锌缺乏患病率为50%。8.3%的患者贫血。维生素缺乏率较高,主要集中在维生素A和维生素E:58.3%的患者维生素A缺乏,50%的患者维生素E缺乏。无症状胆结石患病率从术前的0%显著升至术后的41.7%。

结论

BPD-DS在治疗中国肥胖患者方面具有出色的减重效果和合并症缓解情况。然而,BPD-DS术后发现营养缺乏和并发症发生率较高,尤其是维生素A和维生素E。

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