Experience of Surgical Therapy for Morbidly Obese Patients with Gallstone by Using Laparoscopic Technique Meanwhile_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHENG Fang , ZOU Yiping , LI Weimin , HUANG Hui , CUI Hongtao , DAI Xin , LIU Haorun , JIANG Zhaotao

Department of Hepatobiliary Surgery, The 309th Hospital of PLA, Beijing 100091, China;

Corresponding author：

Keywords：

R657.4; R656.6; R589.2

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Objective To investigate the operating skills for treatment of morbidly obese patients with gallstone by using laparoscopic technique meanwhile. Methods From Oct.2006 to Nov.2009, 178 morbidly obese patients undergoing laparoscopic adjustable gastric banding （LAGB）, in which 18 cases combined with gallstone underwent laparoscopic cholecystectomy （LC） meanwhile. Results All of 18 morbidly obese patients with gallstone underwent LAGB and LC successfully, the operating time was (126±24) min and bleeding volume was (50±16) ml. No serious infectious complications occurred, but 3 cases with low-grade nausea and vomiting, 2 cases with adipose tissue liquefaction in incision, and one case with few seroperitoneun， all were cured conservatively. Conclusion Morbidly obese patients with gallstone undergoing LAGB and LC at the same time by changing site of incision is a safe and effective procedure and a feasible technique.

Citation： ZHENG Fang,ZOU Yiping,LI Weimin,HUANG Hui,CUI Hongtao,DAI Xin,LIU Haorun,JIANG Zhaotao. Experience of Surgical Therapy for Morbidly Obese Patients with Gallstone by Using Laparoscopic Technique Meanwhile. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(6): 606-608. doi: Copy

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12.	Ahmed HA, Petroni ML, Abu-Hamidayyah M, et al. Hydrophobic/hydrophilic balance of proteins: A major determinant of cholesterol crystal formation in model bile[J]. J Lipid Res, 1994； 35（2）: 211-219.
13.	郑成竹, 胡兵. 腹腔镜手术治疗肥胖病的新概念 [J]. 中华消化外科杂志, 2007; 6（3）: 164-165.
14.	Roman S, Napoléon B, Mion F, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy[J]. Obes Surg, 2004； 14(4): 539-544.
15.	Melissas J, Mouzas J, Filis D, et al. The intragastric balloon-smoothing the path to bariatric surgery[J]. J Obes Surg, 2006; 16(7): 897-902.
16.	Melissas J. Laparoscopic adjustable band combined with duodenal swith article [J]. J Obes Surg, 2005; 15(7): 1086-1087.
17.	Melissas J, Christodoulakis M, Spyridakis M, et al. Disorders associated with clinically severe obesity: significant improvement after surgical weight reduction [J]. South Med J, 1998; 91(12): 1143-1148.
18.	李志宏, 李永国. 减重外科进展 [J]. 中国现代手术学杂志, 2008; 12（1）: 72-76.
19.	李威杰. 腹腔镜胃减容手术 [J]. 腹腔镜外科杂志, 2006; 11（2）: 164-167.
20.	邹一平, 李为民, 黄辉, 等. 腹腔镜可调节性胃束带术治疗病态肥胖症伴2型糖尿病的近期疗效 [J]. 中华消化外科杂志, 2008; 7（3）: 171-173.
21.	邹一平, 黄辉, 李为民, 等. 腹腔镜可调节性胃束带术治疗病态肥胖症的近期疗效 [J]. 中华普通外科杂志, 2009; 24（4）: 313-316.

1. Carey MC. Pathogenesis of gallstone [J]. Am J Surg, 1993; 165(4): 410-419.
2. Hyogo H, Tazuma S, Cohen DE. Cholesterol gallstones [J]. Curr Opin Gstroenterol， 2002； 18(3): 366-371.
3. 林琦远，李缨来，兰亚佳，等. 血脂和体重异常增加与胆囊结石危险度的评价 [J]. 中国普外基础与临床杂志, 1999; 6（4）: 218-220.
4. 杨松, 谈永飞, 喻荣彬, 等. 肥胖、血脂和胆石症关系的研究 [J]. 镇江医学院学报, 2000; 10（4）: 655-656.
5. 邹大进. 实用临床肥胖病学 [M]. 北京: 中国医药科技出版社, 1999: 223-228.
6. 郑达武, 胡虞乾, 莫瑞祥, 等. 胆源性胰腺炎的高危因素分析 [J]. 重庆医学, 2007; 36（12）: 1192-1193.
7. 洪磊, 杨文奇, 尹纯林, 等. 瘦素与胆结石形成的关系 [J]. 中华肝胆外科杂志, 2009; 15（5）: 398-400.
8. Méndez-Sánchez N, González V, King-Martínez AC, et al. Plasma leptin and the cholesterol saturation of bile are correlated in obese women after weight loss[J]. J Nutr, 2002; 132（8）: 2195-2198.
9. Hyogo H, Roy S, Cohen DE. Restoration of gallstone susceptibility by leptin in C57BL/6J ob/ob mice[J]. J Lipid Res, 2003; 44(6): 1232-1240.
10. Swartz-Basile DA, Goldblatt MI, Ho Choi S, et al. Biliary lipids and cholesterol crystal formation in leptin-deficient obese mice[J]. HPB, 2006; 8(5): 386-392.
11. Swartz-Basile DA, Lu D, Basile DP, et al. Leptin regulates gallbladder genes related to absorption and secretion[J]. Am J Physiol Gastrointest Liver Physiol, 2007; 293(1): G84-G90.
12. Ahmed HA, Petroni ML, Abu-Hamidayyah M, et al. Hydrophobic/hydrophilic balance of proteins: A major determinant of cholesterol crystal formation in model bile[J]. J Lipid Res, 1994； 35（2）: 211-219.
13. 郑成竹, 胡兵. 腹腔镜手术治疗肥胖病的新概念 [J]. 中华消化外科杂志, 2007; 6（3）: 164-165.
14. Roman S, Napoléon B, Mion F, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy[J]. Obes Surg, 2004； 14(4): 539-544.
15. Melissas J, Mouzas J, Filis D, et al. The intragastric balloon-smoothing the path to bariatric surgery[J]. J Obes Surg, 2006; 16(7): 897-902.
16. Melissas J. Laparoscopic adjustable band combined with duodenal swith article [J]. J Obes Surg, 2005; 15(7): 1086-1087.
17. Melissas J, Christodoulakis M, Spyridakis M, et al. Disorders associated with clinically severe obesity: significant improvement after surgical weight reduction [J]. South Med J, 1998; 91(12): 1143-1148.
18. 李志宏, 李永国. 减重外科进展 [J]. 中国现代手术学杂志, 2008; 12（1）: 72-76.
19. 李威杰. 腹腔镜胃减容手术 [J]. 腹腔镜外科杂志, 2006; 11（2）: 164-167.
20. 邹一平, 李为民, 黄辉, 等. 腹腔镜可调节性胃束带术治疗病态肥胖症伴2型糖尿病的近期疗效 [J]. 中华消化外科杂志, 2008; 7（3）: 171-173.
21. 邹一平, 黄辉, 李为民, 等. 腹腔镜可调节性胃束带术治疗病态肥胖症的近期疗效 [J]. 中华普通外科杂志, 2009; 24（4）: 313-316.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience of Surgical Therapy for Morbidly Obese Patients with Gallstone by Using Laparoscopic Technique Meanwhile

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