Department of General, Oncological and Bariatric Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland.
Department of General Medicine and Gerontocardiology, Centre of Postgraduate Medical Education, Orłowski Hospital, Czerniakowska 231, 00-416, Warsaw, Poland.
Langenbecks Arch Surg. 2023 Feb 11;408(1):84. doi: 10.1007/s00423-023-02785-9.
The aim of the study is to assess the effect of shortening the excluded loop of the small intestine to 150 cm on the effectiveness of one anastomosis gastric bypass (OAGB) in remission of type 2 diabetes with I obesity.
The study included 25 patients with a body mass index (BMI) 30-35 kg/m, with a diagnosis of diabetes mellitus type 2 (T2DM), and undergoing OAGB with excluded 150 cm of the small intestine.
There were no deaths in the study group, bleeding during the postoperative period requiring reoperation, anastomotic leakage/leakage throught mechanical stitching. The mean a glycated haemoglobin (HbA1C) level 12 months after surgery was 6.16 ± 0.96%, corresponding to a 2.29 ± 3.3% decrease. In more than 85% of the patients taking insulin before surgery, the insulin was discontinued in the postoperative period. Additionally, the level of glycaemia was assessed in patients on the day of surgery (163 ± 58 mg/dl) and on the day of discharge from the hospital (4.7 ± 1.3 days)-it was lower by over 18% (133 ± 39.2 mg). Over the period of 12 months following OAGB, there was a reduction in the mean BMI value from 33.5 ± 2 to 25.5 ± 2.5 kg/m and improvement in lipid parameters and mean values of blood pressure.
OAGB with excluded 150 cm of the small intestine has beneficial effect on the remission of T2DM in patients with a BMI of 30-35kg/m and is associated with an acceptable level of complications. The achieved weight loss after surgery is satisfactory.
本研究旨在评估将小肠道的旷置长度缩短至 150cm 对肥胖合并 2 型糖尿病患者行一吻合口胃旁路术(OAGB)缓解病情的效果。
本研究纳入 25 名 BMI 在 30-35kg/m 之间、诊断为 2 型糖尿病(T2DM)的患者,行 OAGB 术,旷置 150cm 的小肠。
研究组无死亡病例,无术后出血需再次手术,无吻合口漏/机械缝合渗漏。术后 12 个月平均糖化血红蛋白(HbA1C)水平为 6.16±0.96%,下降 2.29±3.3%。术前使用胰岛素的患者中,85%以上在术后停用胰岛素。此外,在手术当天(163±58mg/dl)和出院当天(4.7±1.3 天)评估患者的血糖水平,均降低了 18%以上(133±39.2mg/dl)。在 OAGB 术后 12 个月期间,平均 BMI 值从 33.5±2kg/m 降至 25.5±2.5kg/m,血脂参数和平均血压值也得到改善。
对于 BMI 在 30-35kg/m 之间的患者,行旷置 150cm 小肠的 OAGB 对 T2DM 的缓解有有益效果,且并发症发生率可接受。术后体重减轻令人满意。