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中华腔镜外科杂志(电子版) ›› 2016, Vol. 09 ›› Issue (06) : 378 -381. doi: 10.3877/cma.j.issn.1674-6899.2016.06.016

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综述

腹腔镜胃袖状切除术胃漏的诊断和处理
张若涵1, 杨雁灵1,(), 丁睿1, 窦科峰1, 陶开山1   
  1. 1. 710032 西安,第四军医大学西京医院肝胆外科
  • 收稿日期:2016-11-14 出版日期:2016-12-30
  • 通信作者: 杨雁灵

Diagnosis and treatment of the leak after laparoscopic sleeve gastrectomy

Ruohan Zhang1, Yanling Yang1,(), Rui Ding1, Kefeng Dou1, Kaishan Tao1   

  1. 1. Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
  • Received:2016-11-14 Published:2016-12-30
  • Corresponding author: Yanling Yang
  • About author:
    Corresponding author: Yang Yanling, Email:
引用本文:

张若涵, 杨雁灵, 丁睿, 窦科峰, 陶开山. 腹腔镜胃袖状切除术胃漏的诊断和处理[J/OL]. 中华腔镜外科杂志(电子版), 2016, 09(06): 378-381.

Ruohan Zhang, Yanling Yang, Rui Ding, Kefeng Dou, Kaishan Tao. Diagnosis and treatment of the leak after laparoscopic sleeve gastrectomy[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(06): 378-381.

近年来,肥胖症及肥胖相关的2型糖尿病已成为威胁人类健康的严重问题,随之兴起的减重手术也逐渐被人们所认可。其中腹腔镜下袖状胃切除术(laparoscopic sleeve gastrectomy, LSG)具有技术简单、减重效果显著、并发症发生率更低等优点,因此得到临床医师的青睐。胃漏是LSG术后最为棘手的并发症,发生率为2%~5%,具有治疗周期长、花费成本高的特点。其发病的具体机制尚未阐明,治疗方案仍富争议,国内外研究提出了多种解释及相关处理策略,本文现对目前的研究进展做一总结。

In recent years, obesity and obesity associated type 2 diabetes mellitus are the most serious medical issues which threaten the health of human beings. And bariatric surgery has become more and more popular and been accepted by public. Laparoscopic sleeve gastrectomy (LSG), a kind of bariatric surgeries, got some advantages including simple operation, significant effect of reducing weight and low incidence of complications, thus LSG acquired more favor of clinicians. Leak after LSG is the most feared complication, which got incidence ranging between 2% and 5%, and it always need long treatment time and high cost. However, the mechanism of leak after LSG has not been fully demonstrated and the treatment protocol is still a controversial topic. Since worldwide researches have provided various explanations and therapy strategies, this review will focus on the current research progress.

1
Rosenthal RJ, International Sleeve Gastrectomy Expert P, Diaz AA, et al. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12 000 cases [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2012, 8(1): 8-19.
2
Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy [J]. Obesity surgery, 2008, 18(10): 1323-1329.
3
Gagner M. Obesity: sleeve gastrectomy-the ideal choice for weight-loss surgery [J]. Nature reviews Endocrinology, 2013, 9(7): 382-384.
4
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013 [J]. Obesity surgery, 2015, 25(10): 1822-1832.
5
Yaghoubian A, Tolan A, Stabile BE, et al. Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy achieve comparable weight loss at 1 year [J]. The American surgeon, 2012, 78(12): 1325-1328.
6
Hubbard A, Okazaki T, Laali KK. Halo- and azidodediazoniation of arenediazonium tetrafluoroborates with trimethylsilyl halides and trimethylsilyl azide and sandmeyer-type bromodediazoniation with Cu(I)Br in [BMIM][PF6] ionic liquid [J]. The Journal of organic chemistry, 2008, 73(1): 316-319.
7
Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2008, 4(1): 33-38.
8
Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4888 patients [J]. Surgical endoscopy, 2012, 26(6): 1509-1515.
9
Sarkhosh K, Birch DW, Sharma A, et al. Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide [J]. Canadian journal of surgery Journal canadien de chirurgie, 2013, 56(5): 347-352.
10
Puig CA, Waked TM, Baron TH, et al. The role of endoscopic stents in the management of chronic anastomotic and staple line leaks and chronic strictures after bariatric surgery [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2014, 10(4): 613- 617.
11
Jurowich C, Thalheimer A, Seyfried F, et al. Gastric leakage after sleeve gastrectomy-clinical presentation and therapeutic options [J]. Langenbeck's archives of surgery, 2011, 396(7): 981-987.
12
Moon RC, Shah N, Teixeira AF, et al. Management of staple line leaks following sleeve gastrectomy [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2015, 11(1): 54-59.
13
Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management [J]. World journal of gastroenterology : WJG, 2014, 20(38): 13904-13910.
14
Huang R, Gagner M. A thickness calibration device is needed to determine staple height and avoid leaks in laparoscopic sleeve gastrectomy [J]. Obesity surgery, 2015, 25(12): 2360-2367.
15
Baker RS, Foote J, Kemmeter P, et al. The science of stapling and leaks [J]. Obesity surgery, 2004, 14(10): 1290-1298.
16
Sakran N, Goitein D, Raziel A, et al. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2834 patients [J]. Surgical endoscopy, 2013, 27(1): 240-245.
17
Perez M, Brunaud L, Kedaifa S, et al. Does anatomy explain the origin of a leak after sleeve gastrectomy [J]. Obesity surgery, 2014, 24(10): 1717-1723.
18
ElGeidie A, ElHemaly M, Hamdy E, et al. The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2015, 11(5): 997-1003.
19
马颖璋,朱江帆. 胃漏:袖状胃切除后的棘手问题[J/CD]. 中华腔镜外科杂志:电子版,2013, 6(2): 82-85.
20
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.
21
Fuks D, Dumont F, Berna P, et al. Case report-complex management of a postoperative bronchogastric fistula after laparoscopic sleeve gastrectomy [J]. Obesity surgery, 2009, 19(2): 261-264.
22
Oshiro T, Saiki A, Suzuki J, et al. Percutaneous transesophageal gastro-tubing for management of gastric leakage after sleeve gastrectomy [J]. Obesity surgery, 2014, 24(9): 1576-1580.
23
Oishi H, Shindo H, Shirotani N, et al. A nonsurgical technique to create an esophagostomy for difficult cases of percutaneous endoscopic gastrostomy [J]. Surgical endoscopy, 2003, 17(8): 1224-1227.
24
Puli SR, Spofford IS, 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.
25
Imamura M, Abrams P, Bain C, et al. Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence [J]. Health technology assessment, 2010, 14(40): 1-188.
26
Zachariah PJ, Lee WJ, Ser KH, et al. Laparo-endoscopic gastrostomy (LEG) decompression: a novel one-time method of management of gastric leaks following sleeve gastrectomy [J]. Obesity surgery, 2015, 25(11): 2213- 2218.
27
Court I, Wilson A, Benotti P, et al. T-tube gastrostomy as a novel approach for distal staple line disruption after sleeve gastrectomy for morbid obesity: case report and review of the literature [J]. Obesity surgery, 2010, 20(4): 519-522.
28
Abdemur A, Han SM, Lo Menzo E, et al. Reasons and outcomes of conversion of laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass for nonresponders [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2016, 12(1): 113-118.
29
Chouillard E, Chahine E, Schoucair N, et al. Roux-En-Y fistulo-Jejunostomy as a salvage procedure in patients with post-sleeve gastrectomy fistula [J]. Surgical endoscopy, 2014, 28(6): 1954-1960.
30
Chour M, Alami RS, Sleilaty F, et al. The early use of roux limb as surgical treatment for proximal postsleeve gastrectomy leaks [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2014, 10(1): 106-110.
31
Nedelcu AM, Skalli M, Deneve E, et al. Surgical management of chronic fistula after sleeve gastrectomy [J]. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2013, 9(6): 879-884.
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