Banded sleeve gastrectomy using the GaBP ring--surgical technique

Laparoscopic sleeve gastrectomy (LSG) has been described as the first step of a two-step laparoscopic Roux-en-Y gastric bypass (LRYGB) or biliopancreatic diversion with duodenal switch (BPD-DS) in extremely obese patients. It has also been used as an independent bariatric procedure. Recently a banded sleeve gastrectomy using human dermis was published. Gastric sleeve dilatation is one of the unfavorable postoperative courses that may limit weight loss. Our technique of a banded sleeve gastrectomy using the GaBP Ring Autolock(TM) System to calibrate the sleeve and prevent distal sleeve dilatation is described in this article.     

Organ-sparing gastrectomy in peptic ulcer

Experimental and clinical data show the zone of hormonal stimulation of gastric juice secretion and that of parietal gastric hydrolysis to have well-defined borders coinciding with anatomical reference points, to be characterized by multidirectional gradient and to be a local mechanism regulating secretory and motor gastric activity. The condition of the lesser curvature ++muco-epithelial complex is one of the factors operable in development of gastroduodenal ulcer. It is hold that resection of hormone--contact zone of the stomach is a preserving, effective and available means of surgical management of gastroduodenal ulcer.     

腹腔镜辅助下胃癌根治术的护理体会

<正>随着微创技术的不断进展,腹腔镜胃癌根治术广泛应用于临床,并且与传统的开腹手术比较具有创伤小、术后恢复快、并发症少等优点[1]。合理的护理对保证手术成功及减少并发症的发生意义重大[2]。目前,有关腹腔镜辅助下胃癌根治术的护理经验不足,为了探讨腹腔镜下胃癌根治术的护理方法,我们对2011年以来我院普通外科68例行腹腔镜下胃癌根治术患者的护理体会总结汇报如下。1资料与方法1.1临床资料     

传统手工缝合与吻合器在胃大部切除中的临床应用分析

随着医学的发展，吻合器已广泛应用于各种胃肠吻合，传统的手工缝合与吻合器各有优点和局限性，合理利用正确的方法进行手术是成功的关键。因此，严格掌握好手工缝合和吻合器的特点及适应范围，是减少术后并发症的关键。本文共搜集总结我附院及教学医院2003年1月至2009年12月胃大部切除320例，根据患者意愿采用手工缝合157例，吻合器吻合163例。现将临床结果分析报告如下。     

Electrogastrographic activity in patients who received proximal gastrectomy plus jejunal interposition or total gastrectomy plus jejunal interposition.

Electrogastrograms (EGGs) were recorded in patients both before and after receiving proximal gastrectomy plus jejunal interposition (PGJI) or just after receiving total gastrectomy plus jejunal interposition (TGJI). Intraluminal pressure was also recorded in some postoperative patients. The EGG 3 cpm component (2.5-4.9 cpm) remained after PGJI, but subsequently decreased with a significant reduction in the preoperative to postoperative ratio of the 3 cpm components (P<0.05). The mean frequency of the 3 cpm components increased significantly after PGJI (P<0.05) and its instability factor increased. The EGG 10 cpm components became relatively dominant compared to other frequency components in 2 out of 8 of patients having PGJI but the mean amplitude of 10 cpm decreased. In TGJI patients, only the 10 cpm component was conspicuous in EGG as in the case of total gastrectomy and Roux en Y anastomosis procedures. The spectral frequencies of intraluminal pressure in the interposed jejunum were similar to the EGG of 10 cpm components both in the case of PGJI and TGJI patients. In conclusion, surface EGG could record the electrical activities of the interposed jejunum more easily in patients having had TGJI than in PGJI.     

Vibrio cholerae bacteremia associated with gastrectomy.

Bacteremia due to Vibrio cholerae is rare. Each of 15 cases previously reported in the English language literature occurred in the setting of immune deficiency. We describe an instance of non-serogroup O1 V. cholerae septicemia in an otherwise healthy patient. Susceptibility to such infection may have been enhanced by a prior gastrectomy for duodenal ulcer.     

腹腔镜胃癌D2根治术和开腹胃癌D2根治术中患者炎症反应比较

目的：比较腹腔镜胃癌D2根治术和开腹胃癌D2根治术对患者炎症因子的影响。方法：选取96例胃癌患者随机分为腹腔镜组和开腹组,腹腔镜组采用腹腔镜胃癌D2根治术治疗,开腹组采用开腹D2根治术治疗,比较两组术前及术后CRP、IL-6、TNF-α及IL-10水平。结果：腹腔镜组术中出血量明显少于开腹组,手术时间、术后排气时间及术后下床活动时间少于开腹组,差异比较有统计学意义(P<0.05);两组术后1 d CRP、IL-6、TNF-α及IL-10水平较术前明显升高,差异比较有统计学意义(P<0.05);腹腔镜组术后CRP、IL-6、TNF-α水平明显低于开腹组,IL-10水平高于开腹组,差异比较有统计学意义(P<0.05)。结论：腹腔镜胃癌D2根治术较开腹胃癌D2根治术炎症反应轻,创伤小,可在临床上推广。