Comparative Study Of Two Kinds Of Digestive Tract Reconstruction In The Treatment Of Gastric Cancer Complicated With Type

Objective:By measuring the levels of fasting blood glucose, blood sugar of two hours after the meal, FFA, and leptin before and after gastric bypass surgery or Billroth I operation for patinets of gastric cancer combined with type2diabetes mellitus,We explore the mechanism of Roux en-Y operation on treating type2diabetes mellitus.Method:50patinets of gastric cancer combined with type2diabetes mellitus respectively accept two different digestive tract reconstruction surgeries(Roux en-Y group34cases, Billroth I group of16cases) during May2010-March2014in the Department of General surgery, Yangzhou Subei Hospital.We Compared the changes of the levels of fasting blood glucose, blood sugar of two hours after the meal, FFA, and of leptin preoperative and postoperative week,3months after operation and6months after operation and made statistical analysis. Compared the regression in diabetes between two groups. Analyzed the possible mechanisms of Roux en-Y operation curing type2diabetes mellitus.Result:There was a significant difference among all indicators preoperative and postoperative week,3months after operation and6months after operation for patients who accept Roux en-Y operation(P<0.05). There was no difference among all indicators preoperative and postoperative week,3months after operation and6months after operation for patients who accept Billroth I operation(P>0.05).Conclusion:Patients with gastric cancer combined with type2diabetes mellitus who accepted total gastrectomy and Roux en-Y operation have improved sugar metabolism condition after surgery. Not only did Radical total gastric resection+Roux en-Y have no effect for the standardization of the gastric cancer treatment but also could reduce the complications of gastric cancer radical surgery such as alkaline reflux gastritis, etc, in addition, it has achieved good curative effect on the treatment of type2diabetes,so it was a better way of operation curing type2diabetes.There were significant differences on free fatty acids, leptin after gastric bypass surgery on patients with type2diabetes mellitus, Roux en-Y operation could reduce insulin resistance, which might be one of the operation mechanisms of hypoglycemic effect of this surgery.