腹腔镜胃肠部分切除术治疗重度肥胖症  

Laparoscopic partial gastrectomy and enterectomy for morbid obesity

作　　者：王跃东[1] 叶再元[1] 莫大超[1] 竺杨文[1] 谢志杰[1] 

机构地区：[1]浙江省人民医院普外科,杭州310014

出　　处：《中华普通外科杂志》2009年第4期307-309,共3页Chinese Journal of General Surgery

摘　　要：目的探讨腹腔镜下袖套式胃大部切除和部分小肠切除术治疗重度肥胖症的手术方法、安全性和近期疗效。方法从2006年12月至2007年9月，为10例重度肥胖症患者进行了腹腔镜下袖套式胃大部切除和部分小肠切除术。手术包括3部分：（1）自大弯侧距幽门5-6cm处起垂直向上至贲门左侧His角，用内镜下切割吻合器向上切除大弯侧胃，保留和形成宽约2-3cm的小弯侧管状胃；（2）切除大网膜；（3）切除约1／3-2／5的小肠。结果本组10例腹腔镜下袖套式胃大部切除和部分小肠切除术全部完成，无1例需中转开腹手术。手术中位时问3．1h，无术后并发症，术后平均住院7d。10例患者术前平均体质量指数为36．1kg／m^2，术后1个月、3个月和6个月平均体质量指数分别减少了4．1kg／m^2、5．6kg／m^2和7．3ks／m^2，平均体重分别减轻11．7kg、17．5kg和22．0kg。结论腹腔镜下袖套式胃大部切除和部分小肠切除术治疗重度肥胖症安全性高、近期疗效满意。Objective To explore the short-term result and safety of laparoscopic sleeve gastrectomy and partial enterectomy for the treatment of morbid obesity. Methods Ten patients underwent laparoscopic sleeve gastrectomy, omentectomy, and partial enterectomy as a treatment option for weight reduction between December 2006 and September 2007. The procedure included 70% - 75% vertical （sleeve） gastrectomy, omentectomy, and 1/3 to 2/5 enterectomy preserving proximal jejunum and most of the ileum. Results Laparoscopy was completed in all patients, no conversion to open surgery. The operation time averaged at 3.1 hours （ range 2. 5 - 3.5 hours）, and there was no postoperative complications. The median postoperative hospital stay was 7 days （ range 6 - 8 days ）. Mean preoperative BMI was 36. 1 （ 32. 0 - 40. 5 ） kg/m^2. Mean decrease in BMI was 4. 1 （ 3.0 - 4. 7 ） kg/m^2, 5.6 （ 3.2 - 9. 0 ） kg/m^2, and 7. 3 （3.2- 10.7） kg/m^2 respectively, and mean weight loss at postoperative 1,3, and 6 months was 11.7 （7-15） kg, 17.5（8 -25） kg, and 22.0 （8 -32） kg respectively. Conclusion Laparoscopic sleeve gastrectomy with omentectomy and partial enterectomy is an effective and safe surgical option for the treatment of morbid obesity.

关 键 词：肥胖症 病态 腹腔镜检查 胃切除术 小肠切除术 

分 类 号：R686[医药卫生—骨科学]