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Mohammad Javad Farzadmanesh¹, Masoumeh Shahsavan¹, Shahab Shahabi Shahmiri^2,3

¹Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

Obesity surgery

|November 27, 2024

概括

经过一次解肠胃绕道术 (OAGB) 后的胆囊切除术不会改变胃袋中的胆汁反流 (BR). 然而,它增加了进入胃残留的胆汁反流,可能会造成长期伤害.

科学领域:

腹部外科腹部外科
胃肠病学胃肠病学
消化器官手术消化器官手术

背景情况:

胆汁反流 (BR) 是一种已知的并发症,它是在一个解肠胃旁路术 (OAGB) 之后出现的.
胆囊切除术,特别是在没有先前减肥手术的患者中,已与BR的增加有关.
胆囊切除术对BR的影响,特别是在OAGB之后,需要进一步调查.

研究的目的:

评估同时或随后的胆囊切除术对曾经经经历过一次解肠胃旁路术 (OAGB) 的患者胆汁反流 (BR) 的影响.
为了比较BR在OAGB患者的发病率和位置,有和没有胆囊切除病史.

主要方法:

一项前性观察性研究包括34名患有肥胖症的成年患者接受初级OAGB.
患者被分为两组:带有胆囊切除术的OAGB (OAGB+LC,n=17) 和没有胆囊切除术的OAGB (OAGB,n=17).
评估包括食管胃管腺镜检查 (EGD),GERD-Q问卷和肝胆乳酸扫描 (HIDA) 来评估GERD和BR.

主要成果:

在这两组中都没有检测到BR进入食道的情况.
胃囊中的BR发生在OAGB组的23.5%和OAGB+LC组的35.3% (P=0.452).
在1名患者 (OAGB组) 和5名患者 (OAGB+LC组) 中观察到BR进入胃残留物 (P=0.072),表明在胆囊切除术后残留BR增加的趋势.

结论:

与OAGB同时或之后进行胆囊切除术不会显著改变胃袋内的BR速率.
然而,胆囊切除似乎增加了BR的发病率进入OAGB之后的胃残留物.
这种增加的胃残留的BR可能会带来潜在的长期风险,需要进一步的临床考虑.

关键词:

胆汁反流是什么意思胆汁反流是什么意思胆囊切除术是一种胆囊切除术.通过HIDA扫描,我们可以看到HIDA扫描.一个解剖肠胃绕道.

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