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中华肥胖与代谢病电子杂志 ›› 2021, Vol. 07 ›› Issue (01) : 19 -23. doi: 10.3877/cma.j.issn.2095-9605.2021.01.004

所属专题: 文献

论著

减重代谢手术并发症单中心总结
延冰1, 孙少川1,()   
  1. 1. 250013 济南,山东大学附属济南市中心医院胃肠外科
  • 收稿日期:2020-05-08 出版日期:2021-02-28
  • 通信作者: 孙少川

The complications of bariatric and metabolic surgery in a single-center

Bing Yan1, Shaochuan Sun1,()   

  1. 1. Department of Gastroenterology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, China
  • Received:2020-05-08 Published:2021-02-28
  • Corresponding author: Shaochuan Sun
引用本文:

延冰, 孙少川. 减重代谢手术并发症单中心总结[J]. 中华肥胖与代谢病电子杂志, 2021, 07(01): 19-23.

Bing Yan, Shaochuan Sun. The complications of bariatric and metabolic surgery in a single-center[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(01): 19-23.

目的

总结山东大学附属济南市中心医院胃肠外科减重代谢手术的并发症及处理方法。

方法

回顾性分析自2013年11月至2018年11月在山东大学附属济南市中心医院胃肠外科接受减重代谢手术的230例患者的病例资料,其中行腹腔镜Roux-en-Y胃旁路术(LRYGB)57例和腹腔镜袖状胃切除术(LSG)173例,总结分析并发症、可能原因及处理方法。

结果

230例手术患者,其中18例患者出现手术相关并发症,并发症发生率7.8% (18/230),所有患者均经积极处理后治愈。

结论

本中心减重代谢手术并发症多发生于刚开展工作的早期,对于并发症要及时发现、早期处理。

Objective

To summarize the complications and treatment of bariatric surgery in Jinan Central Hospital Affiliated to Shandong University.

Methods

To retrospectively analyzed the 230 patients from November 2013 to November 2018, including 57cases undergo laparoscopic Roux-en-Y gastric bypass and 173 cases undergone laparoscopic sleeve gastrectomy. Summarizing and analyzing the possible causes and treatment methods of complications.

Results

Operation-related complications occurred in 18 of all the patients, the complication rate was 7.8%(18/230). All patients were cured after active treatment.

Conclusions

All the complications occurred at the beginning of the operation, our experiences were early found, early treatment.

表1 减重代谢手术并发症及例数
[1]
Brito JP, Montori VM, Davis AM. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations[J]. JAMA, 2017, 317(6):635-636.
[2]
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. 中国肥胖和2型糖尿病外科治疗指南(2014) [J]. 中国实用外科杂志, 2014, 34(11):1005-1010.
[3]
中华医学会外科学分会甲状腺及代谢外科学组,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. 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, 2019, 39(4):301-306.
[4]
刘洋,孟化. 代谢手术相关并发症的诊治和预防[J]. 中华肥胖与代谢病电子杂志, 2016, 2(4):201-204.
[5]
Rabl C, Peeva S, Prado K, et al. Early and Late Abdominal Bleeding After Roux-en-Y Gastric Bypass: Sources and Tailored Therapeutic Strategies[J]. Obes Surg, 2011, 21(4):413-420.
[6]
Dillemans B, Sakran N, Van Cauwenberge S, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients[J]. Obes Surg, 2009, 19(10):1355-1364.
[7]
Bellorin O, Abdemur A, Sucandy I, et al. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity[J]. Obes Surg, 2010, 21(6):707-713.
[8]
Chahine E, Kassir R, Dirani M, et al. Surgical Management of Gastro-gastric Fistula After Roux-en-Y Gastric Bypass: 10-Year Experience[J]. Obes Surg, 2018, 28(4):939-944.
[9]
Pauli EM, Beshir H, Mathew A. Gastro-gastric Fistulae Following Gastric Bypass Surgery-Clinical Recognition and Treatment[J].Curr Gastroenterol Rep, 2014, 16(9):405.
[10]
Hammer HF. Medical complications of bariatric surgery: focus on malabsorption and dumping syndrome[J].Dig Dis, 2012, 30(2):182-186.
[11]
Rasmussen JJ, Fuller W, Ali MR. Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients[J]. Surg Endosc, 2007, 21(7):1090-1094.
[12]
Ying VW, Kim SH, Khan KJ, et al. Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies[J]. Surg Endosc, 2015, 29(5):1018-1023.
[13]
Hunt EB, Sullivan A, Galvin J, et al. Gastric aspiration and its role in airway inflammation[J]. Open Respir Med J, 2018, 23(12):1-10.
[14]
Cuomo R, Giardino FR, Nisi G, et al. Aspiration Pneumonia: a Shadow in Post-Bariatric Patient Correlation between aspiration and mini-grastric bypass[J]. Obes Surg, 2019, 29(12):3937-3940.
[15]
Kalarchian MA, Marcus MD, Courcoulas AP, et al. Self-report of gastrointestinal side effects after bariatric surgery[J]. Surg Obes Relat Dis, 2014, 10(6):1202-1207.
[16]
Sakran N, Ilivitzki A, Zeina AR, et al. Splenic abscess after sleeve gastrectomy: a report of two cases[J]. Obes Facts, 2012, 5(4):635-639.
[17]
Rojas A, Opazo M, Munoz P, et al. Splenic gangrene due to Streptococcus anginosus after a sleeve gastrectomy. Report of one case[J]. Rev Med Chil, 2010, 138(12):1539-1543.
[18]
Schiavo L, Scalera G, De Sena G, et al. Nonsurgical management of multiple splenic abscesses in an obese patient that underwent laparoscopic sleeve gastrectomy: case report and review of literature[J]. Clin Case Rep, 2015, 3(10):870-874.
[19]
Singh Y, Cawich S, Aziz I, et al. Delayed splenic abscess after laparoscopic sleeve gastrectomy[J]. BMJ case Rep, 2015.
[20]
Cervera-Hernandez ME, Pohl D. Splenic abscess caused by Streptococcus anginosus following laparoscopic sleeve gastrectomy: a case report of a rare complication of bariatric surgery[J]. J Surg Case Rep, 2017.
[21]
Burgos AM, Csendes A, Braghetto I. Gastric stenosis after laparo-scopic sleeve gastrectomy in morbidly obese patients[J]. Obes Surg, 2013, 23(9):1481-1486.
[22]
Parikh A, Alley JB, Peterson RM, et al. Management options for symptomatic stenosis after laparoscopic vertical sleeve gastrectomy in the morbidly obese[J]. Surg Endosc, 2012, 26(3):738-746.
[23]
Chivot C, Robert B, Lafaye N, et al. Laparoscopic sleeve gastrectomy: imaging of normal anatomic features and postoperative gastrointestinal complications[J]. Diagn Interv Imaging, 2013, 94(9):823-834.
[24]
Ianelli A, Martini F, Schneck AS, et al. Twisted gastric sleeve[J]. Surgery, 2015, 157(1):163-165.
[25]
International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases[J]. Surg Obes Relat Dis, 2012;8(1):8-19.
[26]
Rebibo L, Hakim S, Dhahri A, et al. Gastric Stenosis After Laparoscopic Sleeve Gastrectomy: Diagnosis and Management[J]. Obes Surg, 2016, 26(5):995-1001.
[27]
Gero D, Ribeiro-Parenti L, Marmuse JP. A simple trick to prevent VOMIT after sleeve gastrectomy[J]. Obes Surg, 2015, 25(7):1252-1253.
[28]
Li VKM, Pulido N, Fajnwaks P, et al. Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy[J]. Surg Endosc, 2009, 23(7):1640-1644.
[29]
Himpens J, Dobbeleir J, Peeters G. Long-term Results of Laparoscopic Sleeve Gastrectomy for Obesity[J]. Annals of Surgery, 2010, 252(2): 319-324.
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