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中华普外科手术学杂志(电子版) ›› 2025, Vol. 19 ›› Issue (04) : 461 -466. doi: 10.3877/cma.j.issn.1674-3946.2025.04.029.

综述

袖状胃切除术与胃旁路术对肥胖合并T2DM的治疗效果
陈斌雄1, 谢铭1,()   
  1. 1. 563099 贵州遵义,遵义医科大学附属医院消化病医院,遵义医科大学附属医院普外科
  • 收稿日期:2025-02-20 出版日期:2025-08-26
  • 通信作者: 谢铭
  • 基金资助:
    贵州省卫生健康高质量发展医学科研联合基金项目(2024GZYXKYJJXM156)

The therapeutic effects of sleeve gastrectomy and gastric bypass surgery on obesity complicated with type 2 diabetes mellitus

Binxiong Chen1, Ming Xie1,()   

  1. 1. Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou Province 563000, China
  • Received:2025-02-20 Published:2025-08-26
  • Corresponding author: Ming Xie
引用本文:

陈斌雄, 谢铭. 袖状胃切除术与胃旁路术对肥胖合并T2DM的治疗效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(04): 461-466.

Binxiong Chen, Ming Xie. The therapeutic effects of sleeve gastrectomy and gastric bypass surgery on obesity complicated with type 2 diabetes mellitus[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 461-466.

随着现代社会生活习惯及饮食结构的改变,肥胖症已经成为一种全球性疾病,其发病率正呈逐步攀升趋势,并且肥胖作为诸多慢性疾病发病的危险因素,2型糖尿病的发生也与其关系密切,肥胖往往带来更高的糖尿病发病率,那么肥胖人群如何减轻体重就成为焦点话题。由于保守治疗拥有相应的局限性,减重手术已经成为治疗肥胖的有效手段,对2型糖尿病也有确切的疗效,然而各个术式的适用性也仍未有明确的定论。本文回顾了大量的临床研究,探讨了袖状胃切除术(SG)、Roux-en-Y胃旁路术(RYGB)、单吻合口胃旁路术(OAGB)对肥胖合并T2DM的治疗效果。经回顾发现:三种术式都可以在术后有效地减轻体重,明显改善血糖水平,但袖状胃切除术在改善糖尿病的治疗效果上逊于胃旁路术,所以在面对肥胖合并T2DM的患者时,胃旁路术可能是更优选择。而在胃旁路术中,OAGB因其仅有一个吻合口更受笔者推荐。腹腔镜袖状胃切除术(LSG)因操作简单、不改变胃肠道原有的生理解剖,且疗效确切从而成为全球范围内开展数量最多的减重术式,可能更适合轻、中度肥胖及病程较短的2型糖尿病患者。

With the changes in lifestyle habits and dietary structures in modern society, obesity has become a global disease, and its incidence rate is gradually increasing. Moreover, as a risk factor for the onset of many chronic diseases, obesity is closely related to the occurrence of type 2 diabetes mellitus (T2DM).Obesity often leads to a higher incidence of diabetes. Therefore, how to lose weight for the obese population has become a focal topic. Due to the corresponding limitations of conservative treatment, bariatric surgery has become an effective method for treating obesity and also has a definite therapeutic effect on T2DM. However,the applicability of each surgical procedure still has no clear conclusion. This article reviews a large number of clinical studies and explores the therapeutic effects of sleeve gastrectomy (SG), Roux-en-Y gastric bypass(RYGB), and one anastomosis gastric bypass (OAGB) on obesity complicated with T2DM. Through the review, it is found that all three surgical procedures can effectively reduce weight and significantly improve blood glucose levels after surgery. However, sleeve gastrectomy is inferior to gastric bypass surgery in terms of the therapeutic effect on improving diabetes. Therefore, when dealing with patients with obesity complicated with T2DM,gastric bypass surgery may be a better choice. Among gastric bypass surgeries, OAGB is more recommended by the author because it has only one anastomosis. Laparoscopic sleeve gastrectomy (LSG) has become the most widely performed bariatric surgical procedure globally due to its simple operation, without changing the original physiological anatomy of the gastrointestinal tract, and its definite therapeutic effect. It may be more suitable for patients with mild to moderate obesity and type 2 diabetes mellitus with a shorter disease course.

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