腹腔镜Roux－en－Y胃旁路术

腹腔镜Roux－en－Y胃旁路术(laparoscopic Roux－en－Y gastric bypass, LRYGB)是经典的减重代谢手术术式，属于限制摄入＋减少吸收的混合型减重术式。LRYGB对于2型糖尿病有较高的缓解率，可能与其改变胃肠道激素分泌和旷置十二指肠对胰岛细胞功能的影响有关。LRYGB可以作为合并中重度反流性食管炎或代谢综合征严重的肥胖病人或超级肥胖病人的首选术式。该术式的手术要点包括：①贲门下方建立胃小囊，隔离全部胃底，严格控制胃小囊容积在30 ml以下；②建立食物支和胆胰支，两者长度之和大于200 cm；③严格控制胃肠吻合口直径在1.5 cm以下；④确切关闭系膜缺损预防内疝形成。

Laparoscopic Roux-en-Y Gastric Bypass Surgery

Laparoscopic Roux-en-Y gastric bypass(LRYGB) is a classic bariatric and metabolic surgery, which is a combination of limiting intake and reducing absorption. LRYGB has a higher remission rate for type 2 diabetes, which may be related to the change of gastrointestinal hormone secretion and the effect of bypassing duodenum on the function of islet cells. LRYGB could be used as the first choice for obese patients or super obese patients with severe reflux esophagitis or metabolic syndrome. The main points of this operation include: ① A gastric pouch should be established under the cardia with isolated gastric fundus, ensuring a volume of < 30 ml;② The total length of jejunum including biliopancreatic branch and food branch should be more than 200 cm;③ Diameter of the GJ anastomosis should be < 1.5 cm;④ Mesentery defect should be closed to prevent internal hernia.