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腹腔镜袖状胃切除术联合十二指肠空肠旁路术治疗病态肥胖的短期疗效

Short-Term Outcomes of Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass for Morbid Obesity.

作者信息

Jo Young Gil, Yuem Jeong Hyun, Kim Jong Min, Choi Sung Il

机构信息

Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Department of Surgery, Min General Surgery Hospital, Seoul, Korea.

出版信息

J Metab Bariatr Surg. 2020 Dec;9(2):61-67. doi: 10.17476/jmbs.2020.9.2.61. Epub 2020 Dec 31.

Abstract

PURPOSE

This study aimed to evaluate the safety and feasibility of laparoscopic sleeve gastrectomy with duodenojejunal bypass (SDJB) surgery in Korean patients.

MATERIALS AND METHODS

This was a retrospective study analyzing SDJB surgery with a 200-cm biliopancreatic limb; the surgery was performed between January 2019 and August 2020 in 56 Koreans with morbid obesity. All demographic, clinical, operative, and follow-up data were documented and analyzed for weight loss and diabetes remission efficacy. Safety and feasibility were analyzed in terms of perioperative and postoperative complications. A decrease in the HbA1c value and discontinuation or reduction of anti-diabetics were considered as indicators of improvement in diabetes.

RESULTS

he median operation time was 180.0 min (105-210 min), and the median postoperative hospital stay was 5.0 days (3-35 days). Postoperative complications occurred in two patients who were managed by conversion to Roux-en-Y gastric bypass surgery. Meaningful weight loss was 3.5%, 27.7%, and 54.9% at the 1-month, 3-month, and 6-month follow-ups, respectively. Of the 56 patients, 46 had type 2 diabetes. Among those patients, at the 1-month follow-up, 4/31 patients (12%), at the 3-month follow-up, 22/41 patients (53.6%), and at the 6-month follow-up, 31/42 patients (73.8%) were found to show improvement. Of the patients who received anti-diabetics or insulin therapy, only three (9%) patients continued to receive reduced treatment of diabetes, and the other thirty (91%) discontinued the anti-diabetics.

CONCLUSION

SDJB surgery with a 200-cm biliopancreatic limb was a safe and effective procedure to treat morbid obesity and diabetes.

摘要

目的

本研究旨在评估十二指肠空肠旁路袖状胃切除术(SDJB)在韩国患者中的安全性和可行性。

材料与方法

这是一项回顾性研究,分析了采用200厘米胆胰支的SDJB手术;2019年1月至2020年8月期间,对56例韩国肥胖患者进行了该手术。记录并分析了所有人口统计学、临床、手术及随访数据,以评估体重减轻和糖尿病缓解效果。从围手术期和术后并发症方面分析安全性和可行性。糖化血红蛋白值降低以及抗糖尿病药物停用或减量被视为糖尿病改善的指标。

结果

中位手术时间为180.0分钟(105 - 210分钟),术后中位住院时间为5.0天(3 - 35天)。两名患者出现术后并发症,通过转为Roux-en-Y胃旁路手术进行处理。在1个月、3个月和6个月随访时,有意义的体重减轻分别为3.5%、27.7%和54.9%。56例患者中,46例患有2型糖尿病。在这些患者中,1个月随访时,4/31例患者(12%)改善;3个月随访时,22/41例患者(53.6%)改善;6个月随访时,31/42例患者(73.8%)改善。在接受抗糖尿病药物或胰岛素治疗的患者中,只有3例(9%)患者继续接受减量治疗,另外30例(91%)停用了抗糖尿病药物。

结论

采用200厘米胆胰支的SDJB手术是治疗肥胖症和糖尿病的一种安全有效的方法。

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