腹腔镜袖状胃切除结合十二指肠空肠吻合术治疗肥胖并非酒精性脂肪性肝病的可行性及安全性分析  

Clinical analysis of the feasibility and safety of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy for obesity and non-alcoholic fatty liver disease

作　　者：杨豪俊[1] 焦宇文[1] 刘寒旸 林煌 钱峻[1] Yang Haojun;Jiao Yuwen;Liu Hanyang;Lin Huang;Qian Jun(Department of Gastrointestinal surgery,the 2nd Peoples’Hospital of Changzhou city,Nanjing Medical University,Jiangsu 213000,China)

机构地区：[1]南京医科大学附属常州市第二人民医院胃肠外科,江苏常州213000

出　　处：《中华普外科手术学杂志（电子版）》2020年第5期472-475,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金项目(81700537)。

摘　　要：目的探讨腹腔镜袖状胃切除结合十二指肠空肠吻合术(SADJB-SG)治疗肥胖并非酒精性脂肪性肝病(NAFLD)的可行性及安全性。方法回顾性分析2017年8月至2019年10月97例肥胖并NAFLD患者病例资料。根据手术方式分为SADJB-SG组(45例)和LSG组(腹腔镜袖状胃切除,52例)。采用SPSS 24.0软件进行数据处理,手术相关指标、LSM、CAP等计量资料以(±s)表示,采用独立t检验;并发症等计数资料采用χ2检验,P<0.05为差异具有统计学意义。结果SADJB-SG组手术时间、术中出血量长于LSG组(P<0.05);SADJB-SG组住院时间略高于LSG组,术后并发症总发生率略高于LSG组(20.0%vs.13.5%),但差异无统计学意义(P>0.05);两组术后3个月体重、BMI均比术前明显降低(P<0.05),但两组差异无统计学意义(P>0.05);术后3个月SADJB-SG组LSM、CAP均比LSG组低(P<0.05)。结论SADJB-SG治疗肥胖并NAFLD的临床疗效显著,可有效减轻体重,改善肝功能,且未增加并发症发生率。Objective To investigate the feasibility and safety of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy(SADJB-SG)in the treatment of obese patients with non-alcoholic fatty liver disease(NAFLD).Methods A retrospective analysis were performed in 97 obese patients with NAFLD from August 2017 to October 2019.According to the surgical options,97 patients were divided into SADJB-SG group(n=45)and LSG group(laparoscopic sleeve gastrectomy,(n=52).Statistical analysis were performed by using SPSS 24.0 software.The measurement data such as surgery-related indicators,LSM,and CAP were expressed as(±s),and were examined by using independent t-tests.The incidence of complication were analyzed by usingχ2 test.A P value of<0.05 was considered as statistically significant difference.Results The operation time and blood loss in SADJB-SG group were much longer than those in LSG group respectively(P<0.05);The hospital stay in the SADJB-SG group was slightly longer than that in the LSG group,and the total incidence of postoperative complications was slightly higher than that in the LSG group(20.0%vs.13.5%),without significant difference(P>0.05).3 months after surgery,the body weight and BMI in both groups were significantly lower than those before the operation respectively(P<0.05),without significant difference(P>0.05).LSM and CAP in the SADJB-SG group were higher than those in the LSG group on 3 months postoperation(P<0.05).Conclusion Clinical outcome of SADJB-SG is statisfactory in treating obese patients with NAFLD,including effectively reduce weight and improve liver function without increasing the incidence of complications.

关 键 词：肥胖症 脂肪肝 腹腔镜 胃切除术 十二指肠空肠吻合术 减重效果 

分 类 号：R656.61[医药卫生—外科学] R575.5[医药卫生—临床医学]