切换至 "中华医学电子期刊资源库"

中华肥胖与代谢病电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 135 -139. doi: 10.3877/cma.j.issn.2095-9605.2020.02.012

所属专题: 经典病例 文献

病例报告

腹腔镜袖状胃切除联合胰腺体尾部切除及脾切除术后2月胃漏的诊治
殷国志1, 杨威1, 拓航1, 朱怡凤1, 姚英民1,()   
  1. 1. 710061 西安,西安交通大学第一附属医院
  • 收稿日期:2019-07-30 出版日期:2020-05-30
  • 通信作者: 姚英民
  • 基金资助:
    陕西省自然科学基础研究计划(2017JM8002)

Diagnosis and treatment of stomach leak two months after laparoscopic sleeve gastrectomy combined with pancreatic body and tail excision and splenectomy

Guozhi Yin1, Hang Tuo1, Wei Yang1   

  • Received:2019-07-30 Published:2020-05-30
引用本文:

殷国志, 杨威, 拓航, 朱怡凤, 姚英民. 腹腔镜袖状胃切除联合胰腺体尾部切除及脾切除术后2月胃漏的诊治[J]. 中华肥胖与代谢病电子杂志, 2020, 06(02): 135-139.

Guozhi Yin, Hang Tuo, Wei Yang. Diagnosis and treatment of stomach leak two months after laparoscopic sleeve gastrectomy combined with pancreatic body and tail excision and splenectomy[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2020, 06(02): 135-139.

图1 患者术后2月上消化道造影提示贲门下方造影剂外泄
图2 患者术后2月腹部CT提示左膈下似有少量积液
图3 患者住院后2周上消化道造影提示未见明显造影剂外溢征象
图4 患者术后4月上消化道造影提示造影剂外溢征象
图5 患者术后4月腹部CT提示胃外存在造影剂
图6 患者术后4月胃镜示贲门下胃大弯处可见瘘口(箭头所指处)
图8 患者术后5月后再次复查上消化道造影未见造影剂外溢征象
[1]
Young MT, Gebhart A, Phelan MJ, et al. Use and Outcomes of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Gastric Bypass: Analysis of the American College of Surgeons NSQIP[J]. Journal of the American College of Surgeons, 2015, 220(5): 880-885.
[2]
Bohdjalian A, Langer FB, Shakeri-Leidenmuhler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin[J]. Obesity surgery, 2010, 20(5): 535-540.
[3]
Khoursheed M, Al-Bader I, Mouzannar A, et al. Postoperative Bleeding and Leakage After Sleeve Gastrectomy: a Single-Center Experience[J]. Obesity surgery,2016, 26(12): 2944-2951.
[4]
Goldfeder LB, Ren CJ and Gill JR. Fatal complications of bariatric surgery[J]. Obesity surgery, 2006, 16(8): 1050-1056.
[5]
Montravers P, Augustin P, Zappella N, et al. Diagnosis and management of the postoperative surgical and medical complications of bariatric surgery[J]. Anaesthesia, critical care & pain medicine, 2015, 34(1): 45-52.
[6]
Ferrer-Marquez M, Belda-Lozano R and Ferrer-Ayza M. Technical controversies in laparoscopic sleeve gastrectomy[J]. Obesity Surgery, 2012, 22(1): 182-187.
[7]
Warner DL, Sasse KC Technical Details of Laparoscopic Sleeve Gastrectomy Leading to Lowered Leak Rate: Discussion of 1070 Consecutive Cases[J]. Minimally invasive surgery, 2017,, 2017: 4367059.
[8]
Deitel M, Gagner M, Erickson AL, et al. Third international summit: current status of sleeve gastrectomy[J]. Surg Obes Relat Dis, 2011, 7(6): 749-759.
[9]
Csendes A, Braghetto I, León P, et al. Management of leaks after laparoscopic sleeve gastrectomy in patients with obesity[J]. J Gastrointest Surg, 2010, 14(9): 1343-1348.
[10]
Ruiz-Tovar J, Munoz JL, Gonzalez J, et al. C-reactive protein, fibrinogen, and procalcitonin levels as early markers of staple line leak after laparoscopic sleeve gastrectomy in morbidly obese patients within an Enhanced Recovery After Surgery (ERAS) program[J]. Surgical endoscopy, 2017, 31(12): 5283-5288.
[11]
Cuadrado Ayuso M, Franco Herrera R and Lago Oliver J. Succesful Management of Laparoscopic Sleeve Gastrectomy Leak with Negative Pressure Therapy[J]. Obesity Surgery, 2017, 27(9): 2452-2453.
[12]
Dakwar A, Assalia A, Khamaysi I, et al. Late complication of laparoscopic sleeve gastrectomy[J]. Case reports in gastrointestinal medicine, 2013, 2013(6778): 136153.
[13]
Simon F, Siciliano I, Gillet A, et al. Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time[J]. Obesity surgery, 2013, 23(5): 687-692.
[14]
Puli SR, Spofford IS and Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis[J]. Gastrointestinal endoscopy, 2012, 75(2): 287-293.
[15]
Spicka P. Staple line leak with peritonitis after laparoscopic sleeve gastrectomy - a solution in one to six steps[J]. Bariatric Surgery, 2017, 12(2): 154-159.
[16]
Genc V, Sulaimanov M, Kirimker EO, et al. The use of porcine acellular dermal matrix for management of gastrocutaneous fistula after laparoscopic sleeve gastrectomy[J]. Journal of laparoendoscopic & advanced surgical techniques Part A, 2015, 25(5): 401-405.
[17]
Mahmoud M, Maasher A, Al Hadad M, et al. Laparoscopic Roux En Y Esophago-Jejunostomy for Chronic Leak/Fistula After Laparoscopic Sleeve Gastrectomy[J]. Obesity surgery, 2016, 26(3): 679-682.
[18]
Rosenthal RJ. International Sleeve Gastrectomy Expert PanelConsensus Statement: best practice guidelines based on experienceof >12,000 cases[J]. Surgery for Obesity & Related Diseases, 2012, 8(1): 8-19.
[19]
Rosenthal RJ, Diaz AA, Arvidsson D, et al. International SleeveGastrectomy Expert Panel Consensus Statement: best practiceguidelines based on experience of >12,000 cases[J]. Surg Obes Relat Dis, 2012, 8(1): 8-19.
[20]
Bobowicz M, Lehmann A, Orlowski M, et al. Preliminary Outcomes1Year after Laparoscopic Sleeve Gastrectomy Based on BariatricAnalysis and Reporting Outcome System (BAROS)[J]. Obesity Surgery, 2011, 21(12): 1843-1848.
[1] 何金梅, 尹立雪, 谭静, 张文军, 王锐, 任梅, 廖明娇. 超声心肌做功技术对2型糖尿病患者潜在左心室心肌收缩功能损伤的评价[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1029-1035.
[2] 李永浩, 高雪菲, 郭田田, 张进, 张彩针, 刘静. 肥胖合并甲状腺癌相关机制的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(04): 311-315.
[3] 纪凯伦, 郝少龙, 孙海涛, 韩威. 减重术后胆囊结石形成机制的新进展[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 100-103.
[4] 陈大敏, 曹晓刚, 曹能琦. 肥胖对胃癌患者手术治疗效果的影响研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 651-653.
[5] 李晓晖, 上官昌盛, 向英, 裴芝皆, 车俊志, 谢飞. 3D腹腔镜袖状胃切除术后机体能量代谢与多囊卵巢综合征患者性激素水平关系[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 538-541.
[6] 聂锋, 李婉珍. 不打针不吃药不输液徒手治疗糖尿病一例报道[J]. 中华普外科手术学杂志(电子版), 2023, 17(03): 354-354.
[7] 牛朝, 李波, 张万福, 靳文帝, 王春晓, 李晓刚. 腹腔镜袖状胃切除联合胆囊切除治疗肥胖合并胆囊结石安全性和疗效[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 635-639.
[8] 高文星, 刘浩, 赵稳, 李丁昌, 陈鹏, 金露佳, 刘先强, 董光龙. 减重手术后慢性腹痛的原因与对策[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 149-154.
[9] 汪赓, 夏泽锋, 陶凯雄. 代谢手术在非肥胖型2型糖尿病中的治疗效果及研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 155-160.
[10] 马俊蓉, 叶艳彬. 减重手术后的营养管理与复胖:现状与思考[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 165-172.
[11] 范晓轩, 王娜, 朱丽花, 王亮. 肥胖相关肿瘤研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 173-178.
[12] 李锦亮, 曾茂娟, 钟金宝, 何伟强, 林文新. 司美格鲁肽对肥胖2型糖尿病患者皮肤微循环功能的影响[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 192-196.
[13] 刘玉苓, 王婷婷, 吴高峰, 俞淑静. 健康体检人群内脏脂肪面积与新型炎症标志物的相关性研究[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 197-202.
[14] 刘澳, 周菁, 孙永兵, 和俊雅, 林新贝, 乔琦, 李中林, 张建成, 武肖玲, 邹智, 胡扬喜, 肖新广, 吕雪, 李昊, 李永丽. 减重代谢手术后神经影像改变与认知功能评估的研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 203-208.
[15] 秦梧耀, 高文惠, 崔浩, 尚吉文. 醛固酮与脂肪关系的研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 209-214.
阅读次数
全文


摘要