Author/Editor		Breznikar, Brane
Title		Bariatrična kirurgija v Splošni bolnišnici Slovenj Gradec
Translated title		Bariatric surgery in the Slovenj Gradec General Hospital
Type		članek
Source		Endoskopska Revija
Vol. and No.		Letnik 12, št. 28
Publication year		2007
Volume		str. 125-8
Language		slo
Abstract		Introduction. The beginings of bariatric surgery in the Slovenj Gradec General Hospital and its basic principles are described. Patients and methods. Approximately 100 bariatric operations have been carried out so far. The most common procedure is gastric banding involving exposure of the angle of Hiss and introduction of the »goldfinger« instrument through the pars flaccida. The band is pulled behind the stomach and closed in front of it. It is fixed with suture of the fundus to the left crus and gastric pouch. The reservoir is fixed on the fascia under the left rib arc. The first filling is carried out at six weeks after surgery, and later when needed. The patients are instructed to have small meals and to eat more frequently throughout the day. The first series of 50 bands is presented . Results. In our series, the weight loss was 12.9 kg after the first three months, 22.9 kg after six months and 26.6 kg in one year. Eight patients were followed up for one year, 15 for six months and 48 for three months. Two bands had to be removed, and in one case sleeve gastrectomy was done later on. No patient died. There were no stomach wall lesions, pneumothorax or haemorrhage. Conclusion. Gastric banding is a procedure reserved for selected obese patients. Other bariatric operations, including sleeve gastrectomy and gastric by-pass, were therefore introduced in this hospital.
Summary		Uvod. Opisani so začetki bariatrične kirurgije v Splošni bolišnici Slovenj Gradec in njeni osnovni principi. Bolniki in metode. Do zdaj smo operirali okrog sto bolnikov. Večinoma smo delali želodčno prevezavo s prilagodljivim trakom, pri katerih izprepariramo Hissov kot in skozi pars flacida uvedemo t.i. zlati prst (»gold finger«), s katerim potegnemo trak za želodcem in ga spnemo pred njim. S šivi fundusa na levi krus oz. na proksimalni del želodca trak pričvrstimo na svoje mesto. Rezervoar pričvrstimo na fascijo pod levi reberni lok. Prvič polnimo čez 6 tednov, kasneje po potrebi, raje večkrat po malem. Bolnike spremljamo enkrat mesečno v Klubu operiranih zaradi bolestne debelosti. Obdelali smo prvih 50 želodčnih prevezav. Rezultati. V prvih treh mesecih so osebe shujšale povprečno za 12,9 kg, v šestih za 22,9 in v enem letu za 26,6. Leto dni spremljamo 8 bolnikov, pol leta 15, 48 pa tri mesece. Dvema bolnikoma smo morali trak odstraniti, eni smo kasneje naredili gastrektomijo Sleeve in uspešno hujša. Oboperativne smrtnosti ni bilo, prav tako ne poškodbe želodca, pnevmotoraksa ali krvavitve. Zaključek. Za vse trak ni primeren. Zato smo tudi začeli z gastrektomijami Sleeve in želodčnimo obvodi.
Descriptors		OBESITY, MORBID GASTRIC BYPASS