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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 113 -116. doi: 10.3877/cma.j.issn.1674-3946.2020.02.002

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腹腔镜减重代谢袖状胃手术要点与适应证
朱晒红1,(), 李鹏洲1, 高祥1, 朱利勇1   
  1. 1. 中南大学湘雅第三医院普通外科
  • 收稿日期:2019-09-28 出版日期:2020-04-26
  • 通信作者: 朱晒红

Indications and Key points of laparoscopic sleeve gastrectomy

shaihong Zhu1,(), pengzhou Li1, xiang Gao1, liyong Zhu1   

  1. 1. Department of General surgery, The Third xiangya hospital, Central South University, Hu nan 410008, China
  • Received:2019-09-28 Published:2020-04-26
  • Corresponding author: shaihong Zhu
  • About author:
    Corresponding author: Zhu shaihong , Email:
  • Supported by:
    National Natural Science Foundation of China(NO.81600431)
引用本文:

朱晒红, 李鹏洲, 高祥, 朱利勇. 腹腔镜减重代谢袖状胃手术要点与适应证[J]. 中华普外科手术学杂志(电子版), 2020, 14(02): 113-116.

shaihong Zhu, pengzhou Li, xiang Gao, liyong Zhu. Indications and Key points of laparoscopic sleeve gastrectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(02): 113-116.

腹腔镜袖状胃切除最开始是作为超级肥胖病人的前期手术出现,随后发现单独的腹腔镜袖状胃切除手术可以显著减轻体重和肥胖相关的并发症,并且具有手术难度低,术后并发症少等优点,因此近些年来应用的越来越多。虽然《中国肥胖与2型糖尿病外科治疗指南(2019)》对于腹腔镜袖状胃切除手术要点及适应证进行了进一步的规范,但由于中国开展减重代谢手术时间较短,手术不规范导致的减重效果不佳,严重并发症的情况依然存在。因此手术细节和相关技术要点的进一步优化,必将有利于手术的推广与开展。

Laparoscopic sleeve gastrectomy was the first performed, as a first-stage operative procedure, in treating super-obese patients. It was subsequently found that laparoscopic sleeve gastrectomy could not only significantly reduce weight but also could decrease obesity-related complications. Due to its feasibility and less complications, laparoscopic sleeve gastrectomy has become more and more polular in recent years. Although the indications and main points of laparoscopic sleeve gastrectomy have been revised as " Guidelines for Surgical Treatment of Obesity and Type 2 Diabetes in China (2019)" , the standardized operative procedures are still needed to be emphsized at the early stage of bariatric and metabolic surgery in China, so as to achieve better clinical outcome with less complications. Therefore, further optimization of surgical skills detail and related technical points would facilitate the promotion and development of bariatric and metabolic surgery.

图1 腹腔镜减重代谢袖状胃切除术四孔法布局
图2 胃大弯侧向胃幽门游离(距离幽门4~6 cm)
图3 暴露困难可用湿纱布填塞
图4 LSG手术中间入路游离胃底
图5 胃切割时向上"挑"起,使胃内液体进入被切除部分
图6 胃镜观察胃切缘无活动性出血(胃底已完全切除)
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