腹腔镜袖状胃切除+双通路吻合术手术流程与技术要点

Surgical process and technical points of laparoscopic sleeve gastrectomy with transit bipartition

减重代谢手术治疗病态肥胖及相关合并症在世界范围内已得到公认,各国亦相继发布诊疗指南。腹腔镜袖状胃切除与胃旁路手术是目前应用较广泛的术式,但其有术后减重不足、复胖、糖尿病复发与远期营养不良性并发症发生率高的缺点。为弥补上述术式的不足,近年在袖状胃基础上附加各种胃肠转流手术。其中,袖状胃切除+双通路吻合手术具有操作简单、治疗效果好、远期并发症发生率低的潜在优势。笔者在国内率先开展此术式,现概述该术式的操作流程与技术要点,供减重代谢外科同道参考。

Bariatric surgery are recognized worldwide for the treatment of morbid obesity and related comorbidities.Therapeutic guidelines have been issued from many countries.Laparoscopic sleeve gastrectomy and gastric bypass are used widely at present.However,both have shortcomings including insufficient weight loss,weight regain,diabetes relapse and high rate of long-term malnutrition.In recent years,operations of sleeve gastrectomy plus various gastrointestinal bypass have been performed increasingly and showed some advantages in order to overcome the shortcomings of above mentioned both procedures.Among these surgical procedures,sleeve gastrectomy with transit bipartition has the potential advantages of simple operation,satisfactory results and low rate of long-term complications.The authors firstly carried out this opera-tion in China and summarized the surgical process and technical points in this article aiming at providing some references to the colleagues of bariatric and metabolic surgery.