袖状胃切除加空肠旷置术的研究现状

Current status of sleeve gastrectomy plus jejunojejunal bypass

目前,袖状胃切除手术(SG)和胃旁路手术(RYGB)已经成为主流减重代谢术式,但是两种手术都不是完美的。而在SG基础上增加空肠旷置(JJB)却可以起到增强减重和降糖效果,目前的临床结果表明,SG-JJB的短期减重效果优于SG,减重降糖效果类似于RYGB,却未出现类似于传统空回肠旁路(JIB)的各种并发症。因此,现有证据表明,SG-JJB是安全有效的减重代谢术式,具有手术相对简单、几乎没有倾倒综合征及溃疡发生的优势,术后经内镜检查胆道,没有旷置的胃囊,在临床有一定的应用前景,但未来需要进一步进行高质量的长期随访研究。

At present,sleeve gastrectomy(SG)and Roux-en-Y gastric bypass(RYGB)have become the major bariatric and metabolic surgical procedures,but neither of them is perfect.Adding jejunojejunal bypass(JJB)to SG can enhance weight loss and hypoglycemic effect.Present clinical results show that the short-term weight loss effect of SG-JJB is better than SG,and the weight loss and hypoglycemic effect is similar to RYGB.However,SG-JJB does not have various complications like traditional jejunal ileal bypass(JIB).The existing evidence shows that SG-JJB is a safe and effective bariatric and metabolic surgery,with relatively simple technical requirement.Meanwhile,SG-JJB has almost no dumping syndrome or ulcers,and facilitates endoscopic examination of the biliary tract,and has no blind gastric pouch.Thus,SG-JJB has some clinical application prospects,but further high-quality research with long-term follow-up is needed.