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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 493 -496. doi: 10.3877/cma.j.issn.1674-3946.2021.05.008

论著

袖状胃切除+单吻合口十二指肠回肠旁路术中幽门下处理策略探讨
曹李1, 陈鹏1, 董光龙1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心普通外科
  • 收稿日期:2020-11-09 出版日期:2021-10-26
  • 通信作者: 董光龙

Discussion on the treatment strategy of subpyloric in Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S)

Li Cao1, Peng Chen1, Guanglong Dong1,()   

  1. 1. Department of General Surgery, First Medical Center, General Hospital of PLA, Beijing 100853, China
  • Received:2020-11-09 Published:2021-10-26
  • Corresponding author: Guanglong Dong
  • Supported by:
    National Natural Science Foundation of China(81773247)
引用本文:

曹李, 陈鹏, 董光龙. 袖状胃切除+单吻合口十二指肠回肠旁路术中幽门下处理策略探讨[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(05): 493-496.

Li Cao, Peng Chen, Guanglong Dong. Discussion on the treatment strategy of subpyloric in Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S)[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(05): 493-496.

目的

探讨袖状胃切除+单吻合口十二指肠回肠旁路术(SADI-S)中幽门下处理策略。

方法

回顾性分析2016年1月至2018年1月20例行3D腹腔镜下SADI-S患者病历及录像资料。

结果

本组20例患者均在3D腹腔镜下完成SADI-S,未出现中转开腹患者。手术时间为(110.4±12.8) min,范围为95~210 min;术中出血量为(32.3±4.7) ml,范围为20~100 ml;术后住院时间为(8.1±1.6) d,范围为5~14 d。术后1例患者出现间断性呕吐泡沫状物质,1例患者术后出现剑突下持续性疼痛,经对症、保守治疗后好转。其余患者未出现吻合口漏、十二指肠残端漏、腹腔出血、肠梗阻及Trocar孔疝等并发症。

结论

SADI-S术中采用隧道式游离幽门下区域,可避免对十二指肠周边血运影响,是一种简便、安全的处理方式。

Objective

To discussion on the treatment strategy of subpyloric in Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S).

Methods

Medical records and video material of 20 patients who received 3D laparoscopic SADI-S at our Center during the period from January 2016 to January 2018 were included in a retrospective analysis.

Results

SADI-S was conducted in all the 20 patients under 3D laparoscopy, without conversion to open surgery. The surgical duration was 95~210 min (mean, 110.4±12.8 min), the intraoperative bleeding volume was 20~100 ml (mean, 32.3±4.7 ml), the postoperative hospital stay was 5~14 d (mean, 8.1±1.6 d). After surgery, 1 patient vomited foam-like substance intermittently; 1 patient experienced persistent pain below the xiphoid process, both improved after symptomatic and conservative treatment. Other patients showed no symptoms of anastomotic leakage, duodenal stump leakage, intraabdominal hemorrhage, ileus, trocar hernia and other complications.

Conclusions

Tunnel-type dissociation of the infrapyloric area in SADI-S could avoid affecting blood supply around duodenum. It is therefore a simple and safe treatment.

图4 将回肠与十二指肠断端近端行连续手工端侧吻合
[1]
王勇,王存川,朱晒红,等. 中国肥胖及2型糖尿病外科治疗指南(2019版)[J]. 中国实用外科杂志201939(4):301-306.
[2]
宋志高,戴晓江,张红兵,等. 超级肥胖患者腹腔镜袖状胃切除术的疗效分析与经验分享[J/CD]. 中华腔镜外科杂志(电子版)201710(1):38-42.
[3]
Bashah M, Aleter A, Baazaoui J, et al. Single Anastomosis Duodeno\ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes[J]. Obesity Surg202030(12):4715-4723.
[4]
张鹏,余波,王廷峰,等. SIPS手术治疗重度肥胖症[J]. 腹腔镜外科杂志201722(1):7-11.
[5]
朱利勇,嵇光年,朱晒红,等. 从术式变迁看减重代谢外科发展趋势[J]. 中国实用外科杂志201939(4):316-321.
[6]
Sanchez-Pernaute A, Rubio Herrera MA, Perez-Aguirre E, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy:Proposed technique[J]. Obes Surg200717(12):1614-1618.
[7]
Shoar S, Poliakin L, Rubenstein R, et al. Single Anastomosis Duodeno-Ileal Switch (SADIS):A Systematic Review of Efficacy and Safety[J]. Obes Surg201828(1):104-113.
[8]
Surve A, Zaveri H, Cottam D. A safer and simpler technique of duodenal dissection and transection of the duodenal bulb for duodenal switch[J]. Surg Obes Relat Dis201612(4):923-924.
[9]
朱江帆. 十二指肠-小肠单吻合口手术的现状与展望[J]. 中华消化外科杂志201918(9):830-833.
[10]
Cottam S, Peter Ng, Sharp L, et al. Single-anastomosis duodenal ileostomy with sleeve is a safe and effective option for patients in an ambulatory surgical center[J]. Surg Obes Relat Dis201915(11):1990-1993.
[11]
Balibrea JM, Vilallonga R, Hidalgo M, et al. Mid-Term Results and Responsiveness Predictors After Two-Step Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy[J]. Obes Surg201727(5):1302-1308.
[12]
Sanchez-Pernaute A, Rubio MA, Cabrerizo L, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients[J]. Surg Obes Relat Dis201511(5):1092-1098.
[13]
Sanchez-Pernaute A, Rubio MA, Aguirre EP, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients[J]. Surg Obes Relat Dis20139(5):731-735.
[14]
Surve A, Rao R, Cottam D, et al. Early Outcomes of Primary SADI-S: an Australian Experience[J]. Obes Surg202030(4):1429-1436.
[15]
Zaveri H, Surve A, Cottam D, et al. A Multi-institutional Study on the Mid-Term Outcomes of Single Anastomosis Duodeno-Ileal Bypass as a Surgical Revision Option After Sleeve Gastrectomy[J]. Obes Surg201929(10):3165-3173.
[16]
姜涛. 腹腔镜胃袖状切除联合单吻合口十二指肠回肠旁路术治疗肥胖症及肥胖相关代谢病17例疗效分析[J]. 中国实用外科杂志202040(4):433-436.
[17]
Moon RC, Kirkpatrick V, Gaskins L, et al. Safety and effectiveness of single-versus double-anastomosis duodenal switch at a single institution[J]. Surg Obes Relat Dis201915(2):245-252.
[18]
Moon RC, Gaskins L, Teixeira AF, et al. Safety and Effectiveness of Single-Anastomosis Duodenal Switch Procedure: 2-Year Result from a Single US Institution[J]. Obes Surg201828(6):1571-1577.
[19]
Finno P, Osorio J, Garcia-Ruiz-de-Gordejuela A, et al. Single Versus Double-Anastomosis Duodenal Switch: Single-Site Comparative Cohort Study in 440 Consecutive Patients[J]. Obes Surg202030(9):3309-3316.
[20]
中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 关于单吻合口十二指肠转位手术(SADI-S/SIPS)的立场声明[J/CD]. 中华肥胖与代谢病电子杂志20195(4):183-186.
[21]
Wu A, Tian J, Cao L, et al. The study of single-anastomosis duodenoileal bypass with sleeve gastrectomy(SADI-S) as the revision surgery for laparoscopic adjustable gastric banding (LAGB)[J]. Surg Obes Relat Dis201814(11):1686-1690.
[22]
曹李,田靖波,董光龙. 袖状胃切除+单吻合口十二指肠回肠旁路术作为超级肥胖病人首选术式的合理性探讨[J]. 腹部外科201932(3):167-171,240.
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