PROSPECTIVE COMPARISON OF GASTRIC AND JEJUNOILEAL BYPASS PROCEDURES FOR MORBID OBESITY
PROSPECTIVE COMPARISON OF GASTRIC AND JEJUNOILEAL BYPASS PROCEDURES FOR MORBID OBESITY
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DOI：
10.1097/00000658-197710000-00012
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发表时间：
1977-01-01
影响因子：
9
通讯作者：
STEVENSON, CC
中科院分区：
文献类型：
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作者：
GRIFFEN, WO;YOUNG, VL;STEVENSON, CC
胃旁路术主要是进行90%的胃隔离，并采用Roux - en - Y式重建。空肠回肠旁路术是在30厘米的空肠和25厘米的末端回肠之间进行端端吻合，被旁路的小肠段通过回肠结肠侧侧吻合术进行减压。胃旁路术组有32例患者，空肠回肠旁路术组有27例患者。两组在年龄、术前体重和身高方面具有可比性。无术后死亡病例，但胃旁路术早期并发症发生率略高，这表明它是一个技术要求更高的手术。远期后遗症在空肠回肠旁路术组更为显著，包括56%的患者出现严重腹泻，74%的患者需要药物治疗。肾结石和胆石症在空肠回肠旁路术组较为复杂，而在胃旁路术后未出现。所有患者在最初的肝活检中均显示脂肪变性。在1年时，空肠回肠旁路术组75%的患者此情况恶化；而胃旁路术组所有患者此情况改善或保持稳定。
The gastric bypass was performed predominantly as a 90% gastric exclusion with a Roux-en-Y reconstitution. The jejunoileal bypass was an end-to-end anastomosis between 30 cm of jejunum and 25 cm of terminal ileum, the bypassed segment of small bowel being decompressed by an end-to-side ileocolostomy. There were 32 patients in the gastric group and 27 in the jejunoileal group. The 2 groups were comparable in age, preoperative weight and height. There were no postoperative deaths, but the gastric bypass operation was associated with a slightly higher early complication rate, indicating that it is a more technically demanding procedure. Late sequellae were more prominent in the jejunoileal bypass group and included significant diarrhea in 56% and need for medication in 74%. Kidney stones and cholelithiasis complicated the jejunoileal group and were not seen after gastric bypass. All patients showed fatty metamorphosis on the original liver biopsy. This had worsened in 75% of the jejunoileal group at 1 yr; it had improved or was stable in all the patients in the gastric group.