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中华肥胖与代谢病电子杂志 ›› 2025, Vol. 11 ›› Issue (03) : 232 -239. doi: 10.3877/cma.j.issn.2095-9605.2025.03.011

综述

腹腔镜袖状胃切除术后胃狭窄的诊治与预防
谭华勇1, 惠远见1, 付应峰1, 张宸炎2, 肖高春1, 杨景哥3,()   
  1. 1442000 十堰,十堰市太和医院(湖北医药学院附属医院)胃肠外科
    2湖北医药学院第一临床学院
    3510632 广州,暨南大学附属第一医院胃肠外科
  • 收稿日期:2025-03-04 出版日期:2025-08-30
  • 通信作者: 杨景哥

Diagnosis, treatment and prevention of gastric stenosis after laparoscopic sleeve gastrectomy

Huayong Tan1, Yuanjian Hui1, Yingfeng Fu1, Chenyan Zhang2, Gaochun Xiao1, Jingge Yang3,()   

  1. 1Department of General Surgery, Shiyan Taihe Hospital (Affiliated Hospital of Hubei Medical Collage)
    2Hubei Medical Collage, Shiyan 442000, China
    3Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510632, China
  • Received:2025-03-04 Published:2025-08-30
  • Corresponding author: Jingge Yang
引用本文:

谭华勇, 惠远见, 付应峰, 张宸炎, 肖高春, 杨景哥. 腹腔镜袖状胃切除术后胃狭窄的诊治与预防[J/OL]. 中华肥胖与代谢病电子杂志, 2025, 11(03): 232-239.

Huayong Tan, Yuanjian Hui, Yingfeng Fu, Chenyan Zhang, Gaochun Xiao, Jingge Yang. Diagnosis, treatment and prevention of gastric stenosis after laparoscopic sleeve gastrectomy[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(03): 232-239.

腹腔镜袖状胃切除术(LSG)因其显著的减重效果及对肥胖相关代谢综合征(如高血压、高脂血症、高尿酸血症)和多囊卵巢综合征的改善作用,已成为病态肥胖及代谢综合征的首选术式。此外,该术式具有操作简便、并发症发生率低、患者耐受性良好等优势。然而,随着减重手术的广泛开展,LSG术后并发症(如胃瘘、出血及狭窄)的发生呈上升趋势。其中,术后胃狭窄(GS)是较为严重的并发症之一,可导致进食困难及营养不良,降低患者的生活质量。本文结合国内外最新研究进展及我科临床经验,系统阐述LSG术后胃狭窄的发病机制、诊断方法、治疗策略及预防措施,以期为临床医生提供全面的诊疗依据,从而降低GS发生率并改善患者预后。

Laparoscopic sleeve gastrectomy (LSG) has become a mainstream surgical procedure for treating morbid obesity and metabolic syndrome due to its proven weight loss effects and significant benefits for obesity-related complications such as hypertension, hyperlipidemia, hyperuricemia, and polycystic ovary syndrome. It also has advantages like the relative ease of the procedure, less surgical complications, and high patient acceptance. However, as weight loss surgeries become more common, complications after sleeve gastrectomy, such as gastric fistula, bleeding, and stenosis, have gradually increased. Postoperative gastric stenosis (GS) is one of the serious complications, which can cause serious eating issues, malnutrition, and impact patients' quality of life. This article looks into how gastric stenosis happens after LSG, drawing on the latest research from both home and abroad, as well as our department's clinical experience in managing postoperative gastric stenosis. The aim is to provide doctors with a comprehensive and systematic reference for the diagnosis, treatment, and prevention of gastric stenosis after LSG, to help lower the chances of this complication and improve the postoperative quality of life for patients.

图1 腹腔镜袖状胃切除术后胃狭窄的治疗流程图
图2 腹腔镜袖状胃切除术四点定位指引切割法
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