胃小弯空肠侧侧吻合在腹腔镜Roux-en-Y胃旁路手术中的应用

目的探讨胃小弯空肠侧侧吻合在腹腔镜Roux-en-Y胃旁路手术中的应用。方法回顾性分析2012年5-11月间在首都医科大学附属北京天坛医院普通外科接受腹腔镜Roux-en-Y胃旁路手术治疗的29例2型糖尿病患者的临床资料，术中均采用直线切割闭合器进行胃小弯空肠侧侧吻合。结果29例患者中男9例，女20例，年龄30-65（平均50．1）岁。所有病例均顺利完成手术．无中转开腹。术后无一例出现胃空肠吻合13出血、吻合13瘘或吻合13梗阻等并发症。术后随访1-7个月未见胃空肠吻合13相关的并发症。结论腹腔镜Roux-en-Y胃旁路手术中采用胃小弯空肠侧侧吻合能准确地控制吻合口大小，避免了镜下缝合操作，操作简单、易于掌握。

Application of side to side anastomosis between the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass

Objective To evaluate the application of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass（LRYGB）. Methods Clinical data of 29 patients with type 2 diabetes mellitus （T2DM） undergoing side to side anastomosis of the lesser curvature of stomach and jejunum in LRYGB from May 2012 to November 2012 in Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University were analyzed retrospectively. Results All the procedures were successfully completed without conversion to laparotomy. The side-to- side anastomosis of the lesser curvature of stomach and jejunum avoided the laparoscopic suture. No gastrojejunostomy anastomotic bleeding, fistula, obstruction and other complications occurred after operation and no complications of gastrojejunostomy anastomosis were found during a follow up of 1 to 7 months. Conclusions Side-to-side anastomosis of the lesser curvature of stomach and jejunum in LRYGB can manipulate the size of anastomosis accurately and avoid the laparoscopic suturing. It is simple and easy to learn.