Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats

作者：Han Li Ou; Zhou Li Hong; Cheng Su Jun; Song Chun; Song Chun Fang

来源：World Journal of Gastroenterology, 2011, 17(45): 5021-5027.

DOI：10.3748/wjg.v17.i45.5021

• Duodenal-jejunal bypass
• Type 2 diabetes mellitus
• Minimally invasive surgery
• Fast-track surgery
• Damage control surgery
• Permissive underfeeding
• Goal-directed volume therapy

AIM: To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass.
METHODS: We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These included: use of anatomical markers to precisely identify Treitz's ligament; careful dissection along surgical planes; careful attention to the choice of regional transection sites; reconstruction using full-thickness anastomoses; use of a minimally invasive procedure with prohemostatic pretreatment and hemorrhage control; prevention of hypo-thermic damage; reduction in the length of the procedure; and accelerated surgical recovery using fast-track surgical modalities such as perioperative permissive underfeeding and goal-directed volume therapy.
RESULTS: The series of modifications we adopted reduced operation time from 110.02 +/- 12.34 min to 78.39 +/- 7.26 min ( P < 0.01), and the procedural success rate increased from 43.3% (13/30) to 90% (18/20) (P < 0.01), with a long-term survival of 83.3% (15/18) (P < 0.01).
CONCLUSION: Using a number of fast-track and damage control surgical techniques, we have successfully established a stable model of gastric bypass in diabetic rats.

• 出版日期2011-12-7
• 单位哈尔滨医科大学