胃袖状切除复胖后再次胃袖状切除术

Revisional laparoscopic sleeve gastrectomy for weight regain after primary sleeve gastrectomy

目的:探讨腹腔镜胃袖状切除术后再次胃袖状切除术的疗效及安全性。方法:回顾分析2016年6月至2018年1月因首次腹腔镜胃袖状切除术后复胖而再次行胃袖状切除术(ReSG)附加小肠转流术7例患者的临床资料,观察手术时间、住院时间、身体质量指数(BMI)变化情况及围手术期并发症。术前7例患者均行上消化道造影,显示胃底残留或残胃扩张。结果:7例手术均顺利完成,无术中并发症发生。中位手术时间125(110,150)min;中位住院时间8(7,9)d;ReSG术前BMI平均(27.6±2.1)kg/m^2,ReSG术后12个月BMI降为(22.3±2.1)kg/m^2。术后1例患者出现机械性肠梗阻,无其他术后并发症发生。结论:再次胃袖状切除术对于因胃底残留或残胃扩张而复胖的胃袖状切除术后患者是安全、有效的修正术式。

Objective:To evaluate the effect and safety of revisional laparoscopic sleeve gastrectomy(ReSG)after failed laparoscopic sleeve gastrectomy(LSG).Methods:Clinical data of 7 patients who underwent ReSG plus jejunoileal bypass after failed primary LSG between Jun.2016 and Jan.2018 were analyzed retrospectively,including operative time,hospital stay,changes of body mass index(BMI)and perioperative complications.Each patient with failure of LSG had an upper gastrointestinal series,which showed a residual fundus or an upper gastric pouch dilatation.Results:All 7 procedures were completed laparoscopically with no intraoperative incidents.The median operative time was 125(110,150)min and the median hospital stay was 8(7,9)d.The mean BMI before ReSG was(27.6±2.1)kg/m^2,which decreased to(22.3±2.1)kg/m^2 at 12 months postoperatively.There were no other postoperative complications except mechanical intestinal obstruction in one patient.Conclusions:ReSG is a safe and effective revisional procedure for patients after failed primary LSG caused by residual gastric fundus or sleeve dilation.