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目的 探讨腹部手术后功能性胃排空障碍的病因、发生机制、诊断和治疗方法。方法 对1994年1月至2002年5月收治的36例腹部手术后胃排空障碍的临床资料进行回顾性分析。结果功能性胃排空障碍均发生于腹部手术后3—12天。35例(97．2％)经非手术治疗于术后13—48天恢复胃动力，痊愈出院，3周内治愈17例(47．2％)，4周内治愈32例(88．9％)，1例(2．8％)因经济原因放弃治疗而死亡。结论 腹部手术后功能性胃排空障碍的病因是多因素的，消化道造影及胃镜检查是诊断胃排空障碍及鉴别机械性梗阻的重要手段。采取非手术疗法可治愈胃排空障碍，应尽量避免再次手术。     

胃转流术对2型糖尿病大鼠的血糖及胰高血糖素样肽-1的影响

目的 观察胃转流术(GBP)对糖尿病大鼠血糖的控制效果及胰高血糖素样肽-1(GLP-1)的影响.方法 采用链脲佐菌素建立糖尿病SD大鼠模型20只,随机分为糖尿病手术组(DO组)和糖尿病对照组(DC组),另取20只非糖尿病大鼠随机分为正常对照组(NC组)和正常手术组(NO组).分别检测各组大鼠术前、术后72 h、1周、4周和8周空腹血糖水平以及血清GLP-1浓度.结果 术前DO组与DC组以及NC组与NO组大鼠空腹血糖之间的比较差异均无统计学意义(P＞0.05);DO组大鼠术后空腹血糖进行性下降,术后8周由术前的(20.84±1.98) mmol/L下降到(5.56±0.11) mmol/L(P＜0.05);DC组大鼠术前及术后各时相的差异无统计学意义(P＞0.05).DO组和NO组大鼠术后血清GLP-1浓度出现明显升高(P＜0.05),术后8周分别由术前的(7.10±0.55)、(10.73 ±0.67) pmol/L上升到(26.48±1.14)、(13.98±0.92) pmol/L(P＜0.05).结论 GBP对2型糖尿病大鼠具有明显的降糖作用,GLP-1的升高在其中起着重要作用,但对正常大鼠血糖无影响.     

胰十二指肠切除术后胃排空延迟的危险因素分析

目的 探讨胰十二指肠切除术后胃排空延迟(delayed gastric emptying,DGE)发生的危险因素.方法 回顾性分析1996年1月至2011年12月213例胰十二指肠切除术的临床资料,分析影响DGE发生的危险因素.结果 213例胰十二指肠切除术共出现DGE 87例,总发生率为40.8％,其中A级30例(14.1％),B级31例(14.5％),C级26例(12.2％).无DGE组、A级DGE组、B级DGE组和C级DGE组的中位术后住院时间分别为21、30.5、32和61 d(x2 =66.171,P=0.000).单因素分析显示手术时间(≥420 min)、术中出血量(≥1000 ml)、Child法消化道重建和术后胰瘘是PD术后DGE的危险因素.Logistic回归分析显示Child法消化道重建、术中出血量(≥1000 ml)和术后胰瘘为术后DGE的独立危险因素,OR值分别为2.098、2.525和4.821.术后胰瘘是C级DGE惟一的危险因素.结论 胰十二指肠切除术后DGE的发生率较高,会明显延长患者住院时间;术中采用Roux-en-Y术式,并尽量减少出血量,有助于减少DGE的发生;术后胰瘘会造成DGE尤其是C级DGE的发生率明显增加.     

食管癌切除术后双相胃排空

目的：进一步研究食管癌工除术后病人固体和液体两种实验餐的胃排空。方法：对１０例食管癌切除术后病人用＾９９ｍＴｃ和＾１１１Ｉｎ分别标定液体和固体实验餐进行胃排空闪烁照相,并与７名下沉人作对比,共检查１２０分钟。结果：病人组液体和固体食物排空率分别为２８．０８％和０,较正常人延迟（８２．０３％和３０．５２％）,差异有显著性（Ｐ〈０．０１）。结论：有因素影响术后胃排空,以迷走神经切除为最主要原因。     

胃切除术后排空障碍的高危因素与治疗

目的 探讨切除术后排空障碍的高危因素及治疗方法。方法 对482例胃切除术病例进行回顾性分析。结果 本组482例中有41例出现胃排空障碍,发生率为8.5%。胃切除术后排空障碍的高危因素有糖尿病（19%）、营养不良（10%）、腹膜炎（17%）、高龄（≥60岁）（14%）以及术后消化道出血（15%）、吻合口漏（33%）、膈下感染、脓肿形成（39%）、胆胰漏（83%）等。结论 术前及术后存在的高危因素可能是胃切除术后排空障碍的原因。胃动力常在4周内恢复,如需再次手术,以全胃切除为宜。     

腹部手术后胃排空障碍的诊断和治疗

目的:探讨腹部手术后功能性胃排空障碍的病因、发病机制、诊断及治疗。方法:对1993年7月至2003年6月收治的29例腹部手术后胃排空障碍的病例资料进行回顾性分析。结果:功能性胃排空障碍发生于术后3～12天,29例胃排空障碍病例均经保守治疗后8～32天痊愈出院,平均15．7天。结论:腹部手术后功能性胃排空障碍的病因是多因素的,胃肠造影及胃镜检查是诊断及鉴别本病的重要方法,采用非手术治疗一般均可治愈,应尽量避免再次手术治疗。     

Whipple术后功能性胃排空障碍诊治问题的探讨

目的：探讨经典Whipple术后功能性胃排空障碍发生的相关因素和诊治经验。方法：回顾性分析1983年9月至2001年8月所行226例经典Whipple手术。结果：226例中62例(27．4％)术后发生功能性胃排空障碍，均行保守治疗，胃蠕动平均恢复时间为2ld，最长为48d。结论：功能性胃排空障碍的发生与术前糖尿病、消化道梗阻、黄疸，术后胰瘘、腹腔感染有关。术后应用生长抑素不会增加发生胃排空障碍的危险性。     

应激状态下胃黏膜损伤与胃排空及胃酸分泌的关系

目的 研究胃黏膜损伤的确切原因和具体过程,为临床防治胃黏膜损伤、胃炎、胃溃疡及胃癌提供新的理论依据.方法 以水浸-束缚应激(WRS)大鼠的方法,将144只Wistar大鼠随机分为9组,每组16只,A、B、c 3组用放射性核素99mTc灌胃测定大鼠胃液相排空率;D、E、F 3组采用手术清除胃内容物并幽门结扎测定胃酸分泌率;G、H、I 3组为手术不清除胃内容物并幽门结扎,评估胃黏膜损伤溃疡指数(UI);分析胃排空率、胃酸分泌和胃黏膜损伤之间的关系.结果 随着wRs时间延长,大鼠胃排空速率明显下降,B组(WRS 2 h)和c组(WRS 4 h)的胃排空速率与A组(正常对照组)相比,差异均有统计学意义(P＜0.01);C组与B组比较,差异有统计学意义(P＜0.01).大鼠胃酸分泌受到显著抑制,E组(WRS 2 h)和F组(WRS 4 h)的胃酸分泌率与D组(正常对照组)相比,差异均有统计学意义(P＜0.01);F组与E组比较,差异无统计学意义(P＞0.05).胃黏膜损伤随着应激时间的延长而加重,清除胃内容物可以有效防治应激引起的胃黏膜损伤,手术对本实验无明显影响.B、C组与A组的胃黏膜损伤UI比较,差异有统计学意义(P＜0.01);C组与B组比较,差异也有统计学意义(P＜0.01);A、D、E、F、G组大鼠未出现胃黏膜损伤,H与E组比较,差异有统计学意义(P＜0.01);I与F组比较,差异也有统计学意义(P＜0.01);A、D、E、F、G组间比较,差异无统计学意义(P＞0.05).H组与B组之间和I组与C组之间比较,差异有统计学意义(P＜0.01).结论 WRS可导致胃排空障碍、胃酸分泌减少和胃黏膜损伤.     

应激状态下胃黏膜损伤与胃排空及胃酸分泌的关系

目的研究胃黏膜损伤的确切原因和具体过程，为临床防治胃黏膜损伤、胃炎、胃溃疡及胃癌提供新的理论依据。方法以水浸-束缚应激（WRS）大鼠的方法，将144只Wistar大鼠随机分为9组，每组16只，A、B、C3组用放射性核素99m^Tc灌胃测定大鼠胃液相排空率；D、E、F3组采用手术清除胃内容物并幽门结扎测定胃酸分泌率；G、H、I3组为手术不清除胃内容物并幽门结扎，评估胃黏膜损伤溃疡指数（uI）；分析胃排空率、胃酸分泌和胃黏膜损伤之间的关系。结果随着WRS时间延长，大鼠胃排空速率明显下降，B组（WRS2h）和C组（WRS4h）的胃排空速率与A组（正常对照组）相比，差异均有统计学意义（P〈0．01）；C组与B组比较，差异有统计学意义（P〈0．01）。大鼠胃酸分泌受到显著抑制，E组（WRS2h）和F组（WRS4h）的胃酸分泌率与D组（正常对照组）相比，差异均有统计学意义（P〈0．01）；F组与E组比较，差异无统计学意义（P〉0．05）。胃黏膜损伤随着应激时间的延长而加重，清除胃内容物可以有效防治应激引起的胃黏膜损伤，手术对本实验无明显影响。B、C组与A组的胃黏膜损伤UI比较，差异有统计学意义（P〈0．01）；C组与B组比较，差异也有统计学意义（P〈0．01）；A、D、E、F、G组大鼠未出现胃黏膜损伤。H与E组比较，差异有统计学意义（P〈0．01）；I与F组比较，差异也有统计学意义（P〈0．01）；A、D、E、F、G组间比较，差异无统计学意义（P〉0．05）。H组与B组之间和I组与c组之间比较。差异有统计学意义（P〈0．01）。结论WRS可导致胃排空障碍、胃酸分泌减少和胃黏膜损伤。     

腹部手术后功能性胃排空障碍的诊断和治疗

目的探讨腹部手术后功能性胃排空障碍的病因、发生机制、诊断和治疗方法。方法对52例腹部手术后胃排空障碍的临床资料进行回顾性分析。结果所有病例经保守治疗后,均在42d内治愈。结论腹部手术后功能性胃排空障碍是综合因素所致,采取非手术疗法可治愈本病,应尽量避免再次手术。     

Effect of different types of fundoplication on the gastric emptying of liquids and gastric compliance in rats

Background/Purpose

The aim of this study is to evaluate the early and late effects of partial fundoplication (PFp) and total fundoplication (TFp) on gastric emptying (GE) and on gastric compliance (GC) in rats.

Methods

One hundred fifty-nine male Wistar rats, 6 to 8 weeks of age and weighing 150 to 250 g underwent sham operation, PFp or TFp. They were randomly divided into early group (group E) and late group (group L), evaluated on the 7th and 28th postoperative days, respectively. Gastric emptying studies were performed with and without short-term induction of GE delay.

Results

Gastric emptying studies: In group E, TFp altered gastric retention when compared with sham subgroup in rats with GE delay. In group L, neither PFp nor TFp produced changes in GE. Gastric volume-gastric compliance studies: In group E, only TFp reduced significantly gastric volume, but both PFp and TFp caused a significant decrease in GC. A trend toward normalization of gastric volume and GC was perceived in group L. Partial fundoplication did not change the intragastric pressure response in either group E or group L. Total fundoplication increased the intragastric pressure significantly in group E, but this difference disappeared on the 28th postoperative day.

Conclusions

Partial fundoplication induces less change in gastric motor physiology than TFp. These findings provide background to explain some differences in the postoperative course after PFp and TFp.     

Effects of retrograde gastric electrical stimulation with pulse trains on gastric emptying of solids and plasma hormones in dogs

BACKGROUND: Retrograde gastric electrical stimulation (RGES) is proposed as a novel therapy for obesity. However, mechanisms of RGES are not fully investigated. The aim of this study was to investigate the effects of RGES with trains of pulses on gastric slow waves, gastric emptying of solids, and plasma concentrations of satiety-related peptides and glucose. METHODS: Seven female beagle dogs implanted with 4 pairs of gastric electrodes on the gastric serosa were studied (control and RGES). Gastric emptying, gastric slow waves, and signs were recorded in each session. Plasma leptin, insulin, glucagons, and glucose were also measured. RESULTS: RGES with pulse trains (a pulse width of 2 milliseconds) significantly decreased gastric emptying of solids and plasma insulin but has no effect on plasma leptin, glucagons, and glucose. CONCLUSION: Acute gastric electrical stimulation with pulse trains is able to decrease gastric emptying of solids and plasma insulin but has no effects on plasma leptin, glucagons, and glucose.     

胃旁路术对糖尿病大鼠的降糖作用及其机制

目的观察胃旁路术(GBP)对链脲佐菌素(STZ)诱发的糖尿病大鼠降糖作用。探讨其机制。方法SD大鼠注射STZ建立糖尿病模型后分为手术组(O组)、假手术组(S组)、饮食控制组(F组)、对照组(C组),每组8只,测术前,术后第1、2、3、4、8周空腹和口服葡萄糖后血糖、胰岛素、胰高血糖素样肽-1(GLP-1)和体重、平均进食量。结果O组GBP后3周,空腹和餐后血糖分别由(16.84±3.82)、(31.88±6.22)mmol/L下降到(13.24±3.53)、(17.35±3.47)mmol/L(P值均＜0.05),空腹和餐后胰岛素分别由(28.66±8.17)、(30.73±8.99)mIU/L上升到(46.48±10.41)、(51.14±11.45)mIU/L(P值均＜0.01)。空腹和餐后GLP-1分别由(7.02±2.10)、(42.20±11.16)pmol/L上升到(25.16±7.30)、(97.83±30.23)pmol/L(P值均＜0.01)。GLP-1和血糖成负相关(P＜0.01),GLP-1和胰岛素成正相关(P＜0.01)。S组体重改变与O组相似,血糖无明显下降；F组控制平均进食量约为O组的1/3并致显著体重下降,血糖下降没有O组明显(P＜0.05)。结论GBP能显著降低STZ大鼠血糖,可能通过术后GLP-1分泌增多起作用。GBP的降糖作用与术后大鼠饮食减少和体重下降无关。     

体表胃肠起搏器治疗术后功能性胃排空障碍的体会

目的探讨体表胃肠起搏器治疗术后功能性胃排空障碍的疗效。方法将我院2004年1月～2006年12月收治的术后功能性胃排空障碍的22例随机分成A组(12例)和B组(10例)。A组予体表胃肠起搏器治疗,B组予常规治疗,比较两组胃动力恢复时间。结果A组胃动力恢复时间为(13.2±4.7)d,B组胃动力恢复时间为(22.5±6.2)d,两组之间有显著性差异(P<0.05)。结论体表胃肠起搏器能有效治疗术后功能性胃排空障碍。     

保留幽门的和标准的胰十二指肠切除术后胃排空延迟的对照研究

目的 探讨保留幽门的胰十二指肠切除术与标准的胰十二指肠切除术术后胃排空延迟的临床特点及防治方法.方法 回顾性分析哈尔滨医科大学附属第一医院胰胆外科2012年1月-2016年7月行标准的胰十二指肠切除术的401例患者的临床资料,其中行保留幽门的胰十二指肠切除术患者35例(8.7％),行标准的胰十二指肠切除术患者366例(91.3％),采用独立样本均数t检验x2检验或Fisher确切概率法、Mann-Whitney Test秩和检验等统计学方法比较保留幽门的胰十二指肠切除术组与标准的胰十二指肠切除术组术后主要并发症的发生情况以及胃排空延迟的转归情况.结果 与标准的胰十二指肠切除术组相比,保留幽门的胰十二指肠切除术组胃排空延迟的发病率(22.9％)显著高于标准的胰十二指肠切除术组(10.9％),P=0.038,其余主要并发症发生率差异无统计学意义(P≥0.05).保留幽门的胰十二指肠切除术组与标准的胰十二指肠切除术组发生胃排空延迟的严重程度(分级比较)相同(P≥0.05),但保留幽门的胰十二指肠切除术组胃排空延迟的平均恢复时间(12.13±3.09)d明显短于标准的胰十二指肠切除术组的(17.28 ±9.63) d(P=O.009).结论 保留幽门的胰十二指肠切除术增加术后发生胃排空延迟的风险,但不增加胃排空延迟的严重程度,相对于标准的胰十二指肠切除术术后胃排空延迟较易恢复,为保留幽门的胰十二指肠切除术患者围手术期管理提供依据.     

红霉素对食管癌术后胃电活动与排空功能的影响

目的 观察食管癌术后红霉素对胃电图和胃排空的影响.方法 将30例食管癌切除食管胃弓上吻合术后患者分成试验组与对照组,每组各15例,分别于术前、术后1、3、6和12个月进行胃电图和放射性核素胃排空检查. 试验组术后于检查前1周开始口服红霉素0.25 g/次,每日3次.结果 术后患者胃电图平均振幅、主频以及正常慢波百分比较术前均降低,术后1个月,试验组各参数均已达到术前水平,而对照组术后1年才达到术前水平 （P＞0.05）.术后患者胃排空明显延缓,术后12个月试验组半量胃排空时间达到术前水平（P＞0.05）,而对照组远未达到术前正常水平 （P＜0.01）.结论 红霉素促进食管癌术后胃电活动和胃排空功能的恢复.胃排空恢复迟于胃电活动的恢复可能与胃壁的缺血、水肿有关.     

保留幽门胃切除术后胃排空功能障碍的原因及防治

保留幽门胃切除术(PPG)治疗早期胃癌(EGC)通过减少胃切除的范围、保留幽门、保留迷走神经能够显著改善患者术后生活质量,降低术后倾倒综合征、胆汁返流及胆石症的发生率。腹腔镜辅助保留幽门胃切除术(LAPPG)将微创理念及功能保留结合,具有低侵袭性,最低限度的小肠麻痹,术后早期康复等优势。然而,无论PPG或LAPPG,术后早期胃排空功能障碍(GEF)的发生率较高,表现为食物长期存留于残胃之中,病人通常有饱腹感。本文综述近几年行PPG术后胃排空功能障碍的相关研究进展,为临床一线外科医生行PPG或LAPPG治疗EGC时防治GEF提供参考建议。     

经皮内镜下空肠造口治疗恶性肿瘤术后胃排空障碍

目的观察经皮内镜下空肠造口(PEJ)行胃引流以及空肠内营养支持对消化道恶性肿瘤手术后胃排空障碍的治疗效果。方法恶性肿瘤术后发生胃排空障碍患者10例,采用拖出法施行PEJ,术后通过PEJ的胃引流管进行胃内减压,通过PEJ空肠营养管进行肠内营养支持。结果10例PEJ均操作成功,未发生出血、窒息、腹膜炎、瘘等严重并发症,仅发生空肠营养管尖端易位1例次,切口处少量渗液感染1例次,均成功处理。PEJ术后平均(23．1±9．3)d胃动力恢复,可夹闭胃引流管。术后1～2 d均可以通过空肠营养管进行肠内营养,术后平均(6．3±2．8)d摆脱肠外营养支持。术后平均(41．4±10．8)d拔除PEJ管,体重较术前增加(3．5±1．8)kg,恢复经口饮食。结论PEJ既可以进行胃减压,又可以进行空肠营养,可应用于胃排空障碍的治疗。     

Delayed gastric emptying: the state of the highest level of evidence

Delayed gastric emptying (DGE) has been regarded as the most common complication after pancreaticoduodenectomy (PD). Opinions about DGE and its incidence widely vary between studies and between institutions. To crystallize current concepts of DGE we resorted to a systematic literature search of level I evidence. We found 16 randomized controlled trials (RCTs) where DGE was measured but only 4 of these trials tested methods to influence DGE (erythromycin, enteral nutrition, or antecolic duodenojejunostomy). Constant heterogeneity for the definition of DGE was observed; 13 RCTs used 6 different clinical definitions based on some form of NG tube requirement after surgery, and the 3 remaining RCTs used non-clinical objective criteria. The most common element of the clinical definitions was the need for an NG tube >10 postoperative days. Ten RCTs used some form of this definition and the reported mean incidence of DGE was 17% however the range varied from 5% to 57%. The trials with the least number of cases appeared to have the widest variation in DGE incidence. We concluded after this systematic review that the disparate opinions about DGE could not be mediated with the highest level of evidence. The studies were underpowered or compromised by a lack of homogeneity in definition and design. The incidence of DGE cannot be succinctly measured; therefore the variables that influence DGE are not understood. We can begin to make progress by using the same definition such as the recently published definition provided by the International Study Group of Pancreatic Surgery.     

胃旁路术治疗2型糖尿病的作用机制

目的 探讨胃旁路术治疗2型糖尿病大鼠的作用机制.方法 将72只8周龄的GK大鼠按照随机数字表法分为手术组、假手术组、饮食控制组和对照组,每组18只.手术组大鼠施行胃旁路术,假手术组大鼠施行离断胃窦十二指肠原位吻合术,饮食控制组大鼠按15 g/d控制每只大鼠进食量,对照组大鼠自由进食.术前、术后第2、4、8周检测各组大鼠空腹、餐后血糖和胰高血糖素样肽-1(GLP-1).术后第2、4、8周检测各组大鼠餐后血糖和GLP-1后处死大鼠(每组6只),取出胰腺组织采用TUNEL法检测胰岛β细胞凋亡情况.采用t检验分析数据.结果 手术组大鼠术前空腹和餐后血糖分别为(16.2±0.8)mmol/L和(31.1±1.1)mmol/L,术后第4、8周逐渐降低为(9.2±0.6)mmol/L和(13.1±0.7)mmol/L、(9.7±0.7)mmol/L和(12.3±0.7)mmol/L,手术前后比较,差异有统计学意义(t=20.7、49.7,18.8、39.0,P<0.05).手术组大鼠术后第4、8周空腹和餐后血糖水平明显低于同时相点的假手术组、饮食控制组和对照组(t=27.7、-57.8,11.3、-59.9,-27.4、-48.2,-13.2、-52.7,-7.0、-24.9,-18.2、-56.4,P<0.05).手术组大鼠术前空腹和餐后GLP-1分别为(10.7±1.0)pmol/L和(42.5±1.2)pmol/L,术后第4、8周逐渐升高为(26.1±0.9)pmol/L和(90.7±1.7)pmol/L、(25.3±1.2)pmol/L和(90.4±2.0)pmol/L,手术前后比较,差异有统计学意义(t=-42.1、-92.4,-29.1、-72.7,P<0.05).手术组大鼠术后第4、8周空腹和餐后GLP-1水平明显高于同时相点的假手术组、饮食控制组和对照组(t=48.0、61.9,38.0、62.2,50.9、65.2,37.0、48.1,27.5、51.6,17.5,52.9,P<0.05).手术组大鼠胰岛随着术后时间的延长,凋亡细胞数逐渐减少,细胞凋亡率明显降低.手术组、假手术组、饮食控制组和对照组术后第4、8周细胞凋亡率分别为5.9%±0.7%、47.2%±1.0%、21.1%±1.2%、46.5%±1.4%和6.3%±1.1%、47.2%±1.0%、21.2%±1.2%、46.0%±1.4%,手术组细胞凋亡率较同时相点的假手术组、饮食控制组、对照组明显降低(t=-82.2、-67.0,-27.1、-22.4,-55.2、-54.6,P<0.05).结论 胃旁路手术后2型糖尿病大鼠血糖降低,GLP-1分泌明显增加,可以显著抑制胰岛β细胞凋亡.

Abstract：

Objective To investigate the mechanism of gastric bypass surgery in the treatment of type 2 diabetes mellitus in a rat model. Methods Seventy-two 8-week-old GK rats were randomly divided into operation group, sham operation group, diet control group and control group (18 rats in each group) according to the random number table. Rats in the operation group and the sham operation group received gastric bypass surgery and transection and reanastomosis of the gastrointestinal tract, respectively. The food intake was set as 15 g/d for each rat in the diet control group, while rats in the control group were fed ad libitum. The levels of fasting blood glucose ( FBG), postprandial blood glucose (PPBG) and glucagon-like peptide-1 (GLP-1) were detected before operation and at postoperative week 2, 4 and 8. The levels of PPBG and GLP-1 were detected at postoperative week 2, 4 and 8, then 6 rats of each group were sacrificed to detect the apoptosis of islet B cells using the TUNEL method. All data were analyzed using the t test. Results In the operation group, the preoperative levels of FBG and PPBG were (16.2±0.8)mmol/L and (31.1 ± 1. L)mmol/L, respectively, which were significantly higher than (9.2± 0.6) mmol/L and (13.1 ±0.7) mmol/L at 4 weeks after the operation, and (9. 7 ± 0. 7) mmol/L and (12. 3 ± 0.7) mmol/L at 8 weeks after the operation (t = 20. 7, 49. 7; 18. 8, 39. 0, P < 0.05 ). The levels of FBG and PPBG before the operation and at 4 and 8 weeks after the operation in the operation group were significantly lower than those in the sham operation group, diet control group and control group at corresponding time points (t = 27.7, -57.8; 11.3, -59.9; -27.4, -48.2; -13.2, -52.7; -7.0, -24.9; -18.2, -56.4, P<0.05). In the operation group, the levels of fasting GLP-1 and postprandial GLP-1 were ( 10. 7 ± 1. 0) pmol/L and (42.5 ±1.2)pmol/L, respectively, which were significantly lower than (26. 1 ±0.9)pmol/L and (90.7 ± 1.7)pmol/L at4 weeks after the operation, and (25.3 ± 1.2)pmol/L and (90.4 ±2.0)pmol/L at 8 weeks after the operation (t=42.1, -92.4; -29.1, -72.7, P <0.05). The levels of fasting GLP-1 and postprandial GLP-1 before the operation and at 4 and 8 weeks after the peration in the operation group were significantly higher than those in the sham operation group, diet control group and control group at corresponding time points (t = 48.0, 61.9; 38.0, 62.2; 50.9, 65.2; 37.0, 48. 1; 27.5, 51.6; 17.5, 52.9, P<0.05). The number of the apoptotic islet β cells in the operation group was decreased with time. The apoptosis rates in the operation group, sham operation group, diet control group and control group were 5.9%±0.7% , 47.2%± 1.0% , 21. 1%± 1. 2% , 46.5%±1.4% at 4 weeks after the operation, and 6.3%±1. 1% , 47.2%±1.0% , 21.2%±1.2% and 46.0% ± 1.4% at 8 weeks after the operation. The apoptosis rates in the operation group were significantly lower than those in the sham operation group, diet control group and control group at corresponding time points (t = -82. 2, - 67. 0; - 27. 1, - 22. 4; - 55. 2, - 54. 6, P < 0.05). Conclusion After gastric bypass surgery, the level of blood glucose reduces and the level of GLP-1 increases which significantly inhibit the apoptosis of islet B cells in rats with type 2 diabetes mellitus.