减肥手术治疗2型糖尿病的前景  

Weight loss surgery for treatment of type 2 diabetes mellitus

作　　者：王存川[1,2] 曹国[1,2] 

机构地区：[1]暨南大学附属第一医院胃肠外科 [2]暨南大学微创外科研究所,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2011年第6期574-578,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家科技部863项目(2007AA02190)

摘　　要：探讨肥胖手术腹腔镜Roux-en-Y胃旁路手术(LRYGB)、腹腔镜胆胰转流术(LBPD)、腹腔镜可调节胃捆绑术(LAGB)、腹腔镜袖状胃切除术(LSG)、十二指肠空肠旁路术(DJB)治疗2型糖尿病的方法、可能的机制及效果。减重和控制2型糖尿病的效果以LBPD最佳,LAGB效果最差,但仅仅保留末段50～100 cm小肠功能的前者并发症及后遗症也很高,围手术期死亡率LBPD最高,LAGB次之,LRYGB和LSG最低。在操作难度上,LBPD最复杂,LRYGB次之,LAGB和LSG相对简单,可见LRYGB在减重和治疗2型糖尿病效果和手术风险上达到相对平衡。2型糖尿病患者成功施行LRYGB后无中转开放,手术操作可行,近期效果明显,远期效果及潜在的并发症有待研究。To investigate the surgical approach, mechanism and effectiveness of laparoscopic Roux-en-Y gastric bypass （LRYGB）, laparoscopic biliopancreatic diversion （LBPD）, laparoscopic adjustablegastric banding （ LAGB）, laparoscopic sleeve gastrectomy （ LSG）, duodenal-jejunal bypass （DJB） surgeryfor treating type 2 diabetes mellitus. Weight loss and control of type 2 diabetes, the effect of the LBPDbest, LAGB least effective, but only keep the last paragraph of 50 - 100 cm the small intestine complica-tions and sequelae of the former function is also very high, the highest perioperative mortality is LBPD,LAGB followed by, LRYGB and LSG minimum. The difficulty in operation, LBPD is most complex,LRYGB followed, LAGB and LSG is relatively simple, showing LRYGB in weight loss and treatment oftype 2 diabetes mellitus to achieve results and the balance of surgical risk. twelve type 2diabetic patientswithout obesity received LRYGB surgery, The changes of the body mass, fasting blood glucose （FBG） ,2-hour postprandial blood glucose （2 h PBG）, C peptide （C-P） and HbAlc% were observed postopera-tively. LRYGB procedures were successfully performed in all the 12 patients with no conversion to opensurgery. The resolution rate was 83.3 % in the type 2 diabetes after 3 months. LRYGB surgery is feasiblefor treatment of type 2 diabetes with good short-term result, but the long-term outcome awaits further re-search.

关 键 词：2型糖尿病 减肥手术 腹腔镜 

分 类 号：R657.5[医药卫生—外科学]