空肠旷置长度在胃旁路术治疗肥胖症及2型糖尿病中的意义

Application value of the jejunal exclusion length in gastric bypass for obesity and type 2 diabetes mellitus

  • 摘要: Roux-en-Y胃旁路术(RYGB)是外科手术治疗肥胖症与2型糖尿病的标准手术方式之一。但目前空肠食物支及胆胰支旷置的长度存在较多争议。基于美国减重外科协会的调查,目前空肠旷置长度,食物支为10~250 cm,胆胰支为35~250 cm。小肠旷置过短,可能影响临床疗效,旷置过长,又容易导致营养障碍、腹泻等并发症发生。小肠旷置长度一定的情况下,不同长度的食物支和胆胰支组合与术后多余体质量下降及血糖等代谢指标变化的相关性也是值得考虑的问题。RYGB术中小肠旷置参数缺乏规范与共识,值得深入研究。为此,笔者深入探讨了RYGB小肠旷置长度与手术疗效的关系。

     

    Abstract: Roux-en-Y gastric bypass (RYGB) is the preferred surgical procedure for obesity and type 2 diabetes mellitus (T2DM). Currently, it is controversial how long the roux limb and biliopancreatic limb should be selected during RYGB. Based on the survey of American Society for Bariatric Surgery (ASBS) (2008), the Roux limb ranged from 10 cm to 250 cm and the biliopancreatic limb ranged from 35 cm to 250 cm. The length of small bowel exclusion may affect the postoperative results.Shorter jejunum exclusion may affect the curative effect, while overlong jejunum exclusion may result in nutritional disorders, diarrhea and other complications. Under the condition of fixed jejunal exclusion,  it is worth exploring the relationship between the postoperative outcome and different parameters of small bowel exclusion. Lacking of consensus and criteria in this field, authors focused on the related references published recent years to summarize the valuable information.

     

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