保留十二指肠球部的暂时性胃成形术的胆胰转流术：3年经验

Biliopancreatic diversion with transitory gastroplasty preserving duodenal bulb: 3 years experience.

作者信息

Vassallo C, Negri L, Della Valle A, Salvaneschi M, Vegezzi C, Griziotti A, Dono C, Mussi P, Bausardo M G, Pietrobono P

机构信息

Interdisciplinary Centre of Obesity, Surgical Division, Stradella's Hospital, Italy.

出版信息

Obes Surg. 1997 Feb;7(1):30-3. doi: 10.1381/096089297765556204.

DOI:10.1381/096089297765556204

PMID:9730535

Abstract

BACKGROUND

The authors have performed 521 bariatric surgery operations (319 restrictive procedures and 202 malabsorptive procedures).

METHODS

During the last few years we have introduced an evolution of biliopancreatic diversion (BPD): BPD with transitory gastroplasty, preserving the duodenal bulb (53 cases). From a technical point of view, the operation consists of a BPD, coupled with a gastroplasty which is transitory due to the use of a polydioxanone (PDS) band. In the last few cases, instead of a VBG (with PDS band) in order to make the operation completely reversible without any suture on the stomach, we made a gastric pouch by banding with PDS calibrated with the same tube as for the Lap-band (20 cc). We maintained completely the duodenal bulb (5 cm from the pylorus), making an end-to-side duodeno-ileal isoperistaltic anastomosis.

RESULTS

With this anastomosis, only 2% of patients developed an anastomotic ulcer. With this new procedure, results have been good in terms of weight loss (similar to that of BPD-AHS) and in nutritional complications. No patient has had hypoalbuminemia, diarrhea or halitosis.

CONCLUSION

BPD with temporary gastric restriction has provided satisfactory results.

摘要

背景

作者已实施521例减肥手术（319例限制性手术和202例吸收不良性手术）。

方法

在过去几年中，我们引入了一种胆胰转流术（BPD）的改良术式：保留十二指肠球部的带暂时性胃成形术的BPD（53例）。从技术角度来看，该手术包括一个BPD，再加上由于使用聚二氧六环酮（PDS）束带而具有暂时性的胃成形术。在最近几例手术中，为了使手术完全可逆且不在胃上进行任何缝合，我们没有采用垂直束带胃成形术（VBG，使用PDS束带），而是用与Lap - band相同规格的管子校准的PDS束带制作了一个胃囊（20毫升）。我们完整保留十二指肠球部（距幽门5厘米），进行端侧十二指肠 - 回肠等蠕动吻合术。