腹腔镜袖状胃切除结合十二指肠空肠吻合术治疗肥胖并非酒精性脂肪性肝病的可行性及安全性分析

目的探讨腹腔镜袖状胃切除结合十二指肠空肠吻合术(SADJB-SG)治疗肥胖并非酒精性脂肪性肝病(NAFLD)的可行性及安全性。 方法回顾性分析2017年8月至2019年10月97例肥胖并NAFLD患者病例资料。根据手术方式分为SADJB-SG组(45例)和LSG组(腹腔镜袖状胃切除，52例)。采用SPSS 24.0软件进行数据处理，手术相关指标、LSM、CAP等计量资料以( ±s)表示，采用独立t检验；并发症等计数资料采用χ²检验，P<0.05为差异具有统计学意义。 结果SADJB-SG组手术时间、术中出血量长于LSG组(P<0.05)；SADJB-SG组住院时间略高于LSG组，术后并发症总发生率略高于LSG组(20.0% vs. 13.5%)，但差异无统计学意义(P>0.05)；两组术后3个月体重、BMI均比术前明显降低(P<0.05)，但两组差异无统计学意义(P>0.05)；术后3个月SADJB-SG组LSM、CAP均比LSG组低(P<0.05)。 结论SADJB-SG治疗肥胖并NAFLD的临床疗效显著，可有效减轻体重，改善肝功能，且未增加并发症发生率。

Clinical analysis of the feasibility and safety of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy for obesity and non-alcoholic fatty liver disease

ObjectiveTo investigate the feasibility and safety of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG) in the treatment of obese patients with non-alcoholic fatty liver disease (NAFLD). MethodsA retrospective analysis were performed in 97 obese patients with NAFLD from August 2017 to October 2019. According to the surgical options, 97 patients were divided into SADJB-SG group (n=45) and LSG group (laparoscopic sleeve gastrectomy, (n=52). Statistical analysis were performed by using SPSS 24.0 software. The measurement data such as surgery-related indicators, LSM, and CAP were expressed as ( ±s), and were examined by using independent t-tests. The incidence of complication were analyzed by using χ² test. A P value of <0.05 was considered as statistically significant difference. ResultsThe operation time and blood loss in SADJB-SG group were much longer than those in LSG group respectively (P<0.05); The hospital stay in the SADJB-SG group was slightly longer than that in the LSG group, and the total incidence of postoperative complications was slightly higher than that in the LSG group (20.0% vs. 13.5%), without significant difference (P>0.05). 3 months after surgery, the body weight and BMI in both groups were significantly lower than those before the operation respectively (P<0.05), without significant difference (P>0.05). LSM and CAP in the SADJB-SG group were higher than those in the LSG group on 3 months postoperation (P<0.05). ConclusionClinical outcome of SADJB-SG is statisfactory in treating obese patients with NAFLD, including effectively reduce weight and improve liver function without increasing the incidence of complications.