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中华肥胖与代谢病电子杂志

中华肥胖与代谢病电子杂志 ›› 2018, Vol. 04 ›› Issue (03) : 146 -150. doi: 10.3877/cma.j.issn.2095-9605.2018.03.005

所属专题： 文献；

论著

腹腔镜袖状胃切除术中大网膜复位的应用及效果
刘华江1, 杨华1, 姜舒文1, 胡嵩浩1, 马茂林1, 吕薇1, 杨景哥1, 王存川1,†()   
  1. 1. 510630　广州，暨南大学附属第一医院肥胖与代谢病外科
  • 收稿日期:2018-05-05 出版日期:2018-08-30
  • 通信作者: 王存川

Application and outcomes of omentum reposition during laparoscopic sleeve gastrectomy

Huajiang Liu1, Wah Yang1, Shuwen Jiang1, Songhao Hu1, Maoling Ma1, Wei Lv1, Jingge Yang1, Cunchuan Wang1,†()   

  1. 1. Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2018-05-05 Published:2018-08-30
  • Corresponding author: Cunchuan Wang
  • About author:
    Corresponding author: Wang Cunchuan, Email:
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引用本文：

刘华江, 杨华, 姜舒文, 胡嵩浩, 马茂林, 吕薇, 杨景哥, 王存川. 腹腔镜袖状胃切除术中大网膜复位的应用及效果[J]. 中华肥胖与代谢病电子杂志, 2018, 04(03): 146-150.

Huajiang Liu, Wah Yang, Shuwen Jiang, Songhao Hu, Maoling Ma, Wei Lv, Jingge Yang, Cunchuan Wang. Application and outcomes of omentum reposition during laparoscopic sleeve gastrectomy[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2018, 04(03): 146-150.

目的

探讨腹腔镜袖状胃切除术（LSG）中大网膜复位的应用及效果。

方法

回顾性分析2015年1月至2017年12月在暨南大学附属第一医院肥胖与代谢病外科行LSG加大网膜复位术的264例肥胖症患者的临床资料，记录患者的体质量指数（BMI）、年龄、性别、合并症及术后并发症。

结果

共行LSG加大网膜复位术264例，其中女性199例，男性65例，平均年龄（29.72±9.79）岁，平均BMI为（36.39±5.22）kg/m2，其中单孔手术18例，同时行胆囊切除术的病例数为17例。有2名患者出现少量呕血，保守治疗后好转。观察到1例发生胃漏，未见扭转和狭窄，无死亡病例。

结论

残胃扭转是袖状胃术后胃功能性狭窄的原因之一。LSG中通过大网膜复位可稳定残胃大弯侧，防止胃扭转。

关键词: 残胃, 袖状胃切除术, 胃扭转, 肥胖症, 大网膜复位
Objective

The aim of this study was to evaluate the application and outcomes of omentum reposition during laparoscopic sleeve gastrectomy.

Methods

A total of 264 patients who underwent omentum reposition and sleeve gastrectomy between January 2015 and December 2017 in the First Affiliated Hospital of Jinan University were included this study. Body mass index, age, gender, comorbidities, and postoperative complications of the patients were recorded as data.

Results

A total of 264 patients underwent sleeve gastrectomy and omentum reposition. There were 198 female and 65 male patients. The mean age of these patients was (29.72±9.79) years. The mean body mass index was (36.39±5.22) kg/m2. 18 patients underwent single-port laparoscopic sleeve gastrectomy. 17 patients underwent simultaneous cholecystectomy. 2 patients had hemorrhage and the patients were treated conservatively. 1 staple-line leakage was observed. Twist, and stricture were not observed and no mortalities were noted.

Conclusions

Sleeve gastrectomy and omentum reposition can prevent the gastric twist, which is a functional cause of gastric stenosis, by stabilizing the greater curvature of stomach wall.

Key words: Gastric remnant, Sleeve gastrectomy, Volvulus, Obesity, Omentum reposition
表1 LSG患者基本情况及术前合并症
年龄（岁） 性别[n（%）] BMI（kg/m2） 术前合并症[n（%）]
女性 男性 糖尿病 高血压 睡眠呼吸暂停综合症 高脂血症
（29.72±9.79） 199（75.4） 65（24.6） （36.39±5.22） 33（12.5） 33（12.5） 79（29.9） 167（63.3）
图1 大网膜复位起始
图2 大网膜复位中部
图3 大网膜复位结束
表2 患者术后情况
手术时间（min） 住院天数（d） 手术方式[n(%)] 并发症[n(%)]
单孔LSG LSG+胃术带拆除术 LSG+胆囊切除术 LSG+食管裂孔疝修补术 LSG+阑尾切除术 LSG+腔镜甲状腺次全切除术 出血 残胃漏 胃狭窄 胃扭转 肺栓塞 死亡
106.3±30.75 9.55±2.77 18（6.8%） 1(0.4%) 17(6.4%) 5(1.9%) 2(0.8%) 4(1.6%) 2(0.8%) 1(0.4%) 0 0 0 0
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