单吻合口胃旁路术  

Oneanastomosisgastricbypass

作　　者：张忠涛[1] Zhang Zhongtao(Department of General Surgery,Beijing Friendship Hospital,Capital Medical University&National Clinical Research CenterforDigestive Diseases,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院普通外科中心普外六科(减重与代谢外科),国家消化系统疾病临床医学研究中心,北京100050

出　　处：《中华普外科手术学杂志（电子版）》2023年第1期20-20,共1页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家科技支撑计划课题(2015BAI13B09);首都卫生发展科研专项(2020-1-2021)。

摘　　要：单吻合口胃旁路术(OAGB)是近年来备受关注的减重代谢手术术式之一,先后于2018年和2022年被国际减重与代谢外科联盟(IFSO)和美国减重和代谢外科学会(ASMBS)推荐为标准减重代谢手术术式。OAGB同Roux-en-Y胃旁路术(RYGB)一样,都属于限制摄人+减少吸收的混合型减重代谢术式。OAGB操作更为简单、围术期风险更低,部分研究提示OAGB有更好的减重降糖效果。OAGB可能会出现顽固性胆汁反流,并且相对于RYCB有更高的营养问题风险。该术式的手术要点包括:(1)胃角下方沿胃小弯建立狭长胃管,长度18~20cm,隔离全部胃底;(2)测量全部小肠长度,旷置全部小肠长度30%,建议至少保留400cm以上的共同通道;(3)完成毕II式胃肠吻合,控制胃肠吻合口直径在3.0cm以下;(4)将吻合口固定于胃窦预防吻合口扭转。One anastomotic gastric bypass(OAGB)is one of the most prevalent bariatric and metabolic surgery in recent years.In 2018 and 2022,it was recommended as the standard bariatric and metabolic surgery by the International Federation for the Surgery of Obesity and Metabolic Disorders(IFSO)and the American Society for Metabolic and Bariatric Surgery(ASMBS).OACB also belongs to the combinational type of bariatric and metabolic surgery.OACB is easier to perform and has lower perioperative risk.Some studies suggest that OACB has a better effect on weight loss and diabetes control.OAGB may have bile reflux and a higher risk of nutritional risks than Roux-en-Y gstric bypass(RYCB).The main points of OAGB include:(1)a long sleeve gastric tube was created first,along the lesser curvature from the antrum to the angle of His.(2)Measure the length of all small intestines,and bypass 30%of the length of all small intestines.It is recommended to reserve at least 400 cm common channel;(3)A Billroth II loop gastroenterostomy was created.The diameter of gastrointestinal anastomosis should be controlled below 3 cm;(4)The gastroenterostomy was anchored to the gastric antrum to prevent loop rotation.

关 键 词：减重代谢手术 单吻合口 胃旁路术 

分 类 号：R656.6[医药卫生—外科学]