Vassallo C, Negri L, Della Valle A, Salvaneschi M, Vegezzi C, Griziotti A, Dono C, Mussi P, Bausardo M G, Pietrobono P
Interdisciplinary Centre of Obesity, Surgical Division, Stradella's Hospital, Italy.
Obes Surg. 1997 Feb;7(1):30-3. doi: 10.1381/096089297765556204.
The authors have performed 521 bariatric surgery operations (319 restrictive procedures and 202 malabsorptive procedures).
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.
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.
BPD with temporary gastric restriction has provided satisfactory results.
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）。
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。
通过这种吻合术，只有2%的患者发生吻合口溃疡。采用这种新术式，在体重减轻（与BPD - AHS相似）和营养并发症方面取得了良好效果。没有患者出现低白蛋白血症、腹泻或口臭。
带暂时性胃限制的BPD取得了令人满意的结果。
