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胃旁路手术后的肠梗阻:一篇叙述性综述

Bowel Obstruction After Gastric Bypass Surgery: A Narrative Review.

作者信息

George Athul Pratheesh, Erekat Khaled W, Mohammed Cara, Kaur Navrooh, Kaur Arshpreet, Adhikari Shushrusha, Rahman Aaliya, Lakshmannagari Himayath, Tavera-Castaño Cesar D, Vallakati Mounika, Kaur Sehajpreet, Nazir Zahra

机构信息

Nephrology, Amala Institute of Medical Sciences, Thrissur, IND.

General Surgery, King Hussein Medical Center, Amman, JOR.

出版信息

Cureus. 2024 Dec 9;16(12):e75386. doi: 10.7759/cureus.75386. eCollection 2024 Dec.

DOI:10.7759/cureus.75386
PMID:39781153
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11709115/
Abstract

Bowel obstruction is a common complication that can affect patients due to different factors, including after a history of gastric bypass surgery. This review was conducted by searching the literature using both PubMed and Google Scholar for articles relating to bowel obstructions. Fifty-six articles were found after applying inclusion and exclusion criteria. Based on the literature search, there are many causes of bowel obstruction, the most common of which include internal hernias, adhesions, and intussusception. Regarding management strategies, surgery is usually the definitive treatment method, but other studies favor a non-surgical approach depending on the specific case. Bowel obstruction is a significant complication that can occur post gastric bypass surgery. This review sheds light on various causes of bowel obstruction, including the possible treatment options, prevention of bowel obstruction that could be achieved by implementing different surgical techniques, the importance of postoperative monitoring, and timely intervention.

摘要

肠梗阻是一种常见的并发症,可因不同因素影响患者,包括在胃旁路手术后。本综述通过使用PubMed和谷歌学术搜索与肠梗阻相关的文章进行。在应用纳入和排除标准后,共找到56篇文章。基于文献检索,肠梗阻有许多原因,其中最常见的包括内疝、粘连和肠套叠。关于治疗策略,手术通常是确定性的治疗方法,但其他研究根据具体情况倾向于非手术方法。肠梗阻是胃旁路手术后可能发生的一种严重并发症。本综述揭示了肠梗阻的各种原因,包括可能的治疗选择、通过实施不同手术技术预防肠梗阻、术后监测的重要性以及及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5d/11709115/40a1f4d68282/cureus-0016-00000075386-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5d/11709115/86d778be69dc/cureus-0016-00000075386-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5d/11709115/40a1f4d68282/cureus-0016-00000075386-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5d/11709115/86d778be69dc/cureus-0016-00000075386-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5d/11709115/40a1f4d68282/cureus-0016-00000075386-i02.jpg

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1
Bowel Obstruction After Gastric Bypass Surgery: A Narrative Review.胃旁路手术后的肠梗阻:一篇叙述性综述
Cureus. 2024 Dec 9;16(12):e75386. doi: 10.7759/cureus.75386. eCollection 2024 Dec.
2
Causes of small bowel obstruction after laparoscopic gastric bypass.腹腔镜胃旁路术后小肠梗阻的原因。
Surg Endosc. 2004 Nov;18(11):1631-5. doi: 10.1007/s00464-004-8804-2. Epub 2004 Oct 11.
3
Bowel obstruction after open and laparoscopic gastric bypass surgery for morbid obesity.用于治疗病态肥胖的开放式和腹腔镜胃旁路手术后的肠梗阻
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Closure of mesenteric defects for prevention of internal hernia after Roux-en-Y gastric bypass in bariatric surgery.肥胖症手术中Roux-en-Y胃旁路术后肠系膜缺损的闭合以预防内疝
Cochrane Database Syst Rev. 2025 Apr 8;4(4):CD014612. doi: 10.1002/14651858.CD014612.pub2.
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Treatment of nonadhesive bowel obstruction following gastric bypass.胃旁路术后非粘连性肠梗阻的治疗
Am J Surg. 2005 May;189(5):532-5; discussion 535. doi: 10.1016/j.amjsurg.2005.01.024.
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Ileal bezoar causing bowel obstruction mimicking an internal hernia in a patient with Roux-en-Y gastric bypass.空肠胃石导致 Roux-en-Y 胃旁路术后患者肠梗阻,类似内疝。
Clin J Gastroenterol. 2020 Dec;13(6):1111-1115. doi: 10.1007/s12328-020-01183-8. Epub 2020 Jul 10.
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Bowel obstruction rates in antecolic/antegastric versus retrocolic/retrogastric Roux limb gastric bypass: a meta-analysis.结肠前/胃前与结肠后/胃后 Roux 袢胃旁路手术的肠梗阻发生率:一项荟萃分析。
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A rare case of internal hernia, intussusception and volvulus following gastric bypass: A case report and literature review.胃旁路术后罕见的内疝、肠套叠和肠扭转病例报告及文献复习
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Bowel gangrene from strangulated Petersen's space hernia after gastric bypass.胃旁路术后彼得森间隙绞窄性疝导致的肠坏疽
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本文引用的文献

1
Multiple Internal Hernias: A Complication of Laparoscopic Roux-en-Y Gastric Bypass.多发性内疝:腹腔镜 Roux-en-Y 胃旁路术的并发症。
CRSLS. 2023 Jan 15;10(4). doi: 10.4293/CRSLS.2023.00040. eCollection 2023 Oct-Dec.
2
Closed or Unclosed Mesentery? A Meta-analysis of Internal Herniation After Laparoscopic Roux-en-Y Gastric Bypass.闭合并发症或未闭合并发症?腹腔镜 Roux-en-Y 胃旁路术后内疝的 Meta 分析。
Obes Surg. 2023 Jun;33(6):1900-1909. doi: 10.1007/s11695-023-06594-3. Epub 2023 Apr 21.
3
Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines.
肥胖症手术后急诊急性腹痛的手术处理:OBA 指南。
World J Emerg Surg. 2022 Sep 27;17(1):51. doi: 10.1186/s13017-022-00452-w.
4
Closed loop small bowel obstruction due to herniation through silastic ring after bariatric surgery.肥胖手术后因疝出硅酮环导致闭环小肠梗阻。
BMJ Case Rep. 2022 May 26;15(5):e250335. doi: 10.1136/bcr-2022-250335.
5
Incidence and treatment of intussusception following Roux-en-Y gastric bypass: a systematic review and meta-analysis.Roux-en-Y 胃旁路术后肠套叠的发生率和治疗:系统评价和荟萃分析。
Surg Obes Relat Dis. 2021 May;17(5):1017-1028. doi: 10.1016/j.soard.2021.01.006. Epub 2021 Jan 21.
6
Laparoscopic management of internal hernia after Roux-en-Y-gastric bypass.Roux-en-Y胃旁路术后内疝的腹腔镜治疗
J Visc Surg. 2020 Oct;157(5):423-427. doi: 10.1016/j.jviscsurg.2020.08.013. Epub 2020 Aug 28.
7
A brief history of bariatric surgery.减重手术简史。
Porto Biomed J. 2017 May-Jun;2(3):90-92. doi: 10.1016/j.pbj.2017.01.008. Epub 2017 Mar 6.
8
S054: incidence and management of jejunojejunal intussusception after Roux-en-Y gastric bypass: a large case series.S054:Roux-en-Y 胃旁路术后空肠空肠套叠的发生率和处理:一项大病例系列。
Surg Endosc. 2020 May;34(5):2204-2210. doi: 10.1007/s00464-019-07009-0. Epub 2019 Aug 5.
9
Bowel obstruction: a narrative review for all physicians.肠阻塞:全体医师的叙述性评论。
World J Emerg Surg. 2019 Apr 29;14:20. doi: 10.1186/s13017-019-0240-7. eCollection 2019.
10
Small bowel obstruction after gastric by-pass: Diagnostic limits and percutaneous drain. A paradigmatic case.
Int J Surg Case Rep. 2019;57:15-18. doi: 10.1016/j.ijscr.2019.02.036. Epub 2019 Mar 5.