腹腔镜Roux-en-Y胃旁路术

Laparoscopic Roux-en-Y gastric bypass

腹腔镜Roux-en-Y胃旁路术(LRYGB)是临床应用广泛的减重代谢手术术式之一,属于限制摄入+减少吸收的混合型减重代谢手术方式。LRYGB对于2型糖尿病有很高的临床缓解率,与其改变胃肠道激素分泌和旷置十二指肠后等对胰岛细胞功能的影响有关。LRYGB可以作为合并中重度反流性食管炎或代谢综合征较严重的肥胖病人或超级肥胖病人的首选术式。该术式的手术要点包括:①贲门下方建立胃小囊,控制胃小囊容积在30 ml以下;②测量全部小肠长度,建立食物支和胆胰支,两者长度之和﹥200 cm;③严格控制胃肠吻合口直径在1.5 cm以下;④确切关闭系膜缺损预防内疝形成。

Laparoscopic Roux-en-Y gastric bypass(LRYGB)is a classic bariatric and metabolic surgery,which is a combination of limiting intake and reducing absorption.LRYGB has a higher remission rate for type 2 diabetes,which may be related to the change of gastrointestinal hormone secretion and the effect of bypassing duodenum on the function of islet cells.LRYGB can be used as the first choice for obese patients or super obese patients with severe reflux esophagitis or metabolic syndrome.The main points of this operation include:①strictly control the volume of gastric pouch<30 ml;②the sum of the length of biliopancreatic limb and food alimenteryalimentary limb is more than 200 cm;③control the diameter of the GJ anastomosis<1.5 cm;④close the mesentery defect to prevent internal hernia.