探讨腹腔镜袖状胃切除术（LSG）联合腹腔镜胆囊切除术（LC）在肥胖合并胆囊结石患者中应用的安全性和有效性。

回顾性分析2020年1月至2022年1月在云南大学附属医院行LSG联合LC的32例肥胖合并胆囊结石患者临床资料。患者均签署知情同意书，符合医学伦理学规定。其中男8例，女24例；年龄20~55岁，中位年龄34岁。观察患者手术并发症及术后6个月疗效。手术前后BMI、血脂、血糖、血压比较采用t检验。

患者均成功实施了LSG联合LC，围手术期均无术后出血、胃瘘、胆漏、胆道损伤、胃腔狭窄等明显并发症。患者体重由术前（97±13）kg降至术后6个月的（70±9）kg，BMI由术前（35.6±6.4）kg/m²降至（23.2±1.3）kg/m²，28例合并高脂血症患者血脂由术前（12.8±7.5）mmol/L降至（2.2±1.1）mmol/L，12例合并2型糖尿病患者空腹血糖由术前（12.5±1.7）mmol/L降至（5.5±0.9）mmol/L，10例合并高血压病患者血压由术前（168±13）/（104±9）mmHg降至（138±11）/（90±6）mmHg（1 mmHg=0.133 kPa） （t=8.641，8.505，31.272，10.443，8.862，8.414；P<0.05）。

肥胖合并胆囊结石患者行LSG联合LC是安全可行的，手术能明显改善肥胖、高血脂、高血压、高血糖等代谢性疾病。联合手术疗效类似于单独LSG和LC，但在减少患者创伤、节约手术费用等方面均有一定的优势。

To evalute the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) combined with laparoscopic cholecystectomy (LC) in the treatment of obese patients complicated with cholecystolithiasis.

Clinical data of 32 patients with obesity complicated with cholecystolithiasis who underwent LSG combined with LC in the Affiliated Hospital of Yunnan University from January 2020 to January 2022 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 8 patients were male and 24 female, aged from 20 to 55 years, with a median age of 34 years. Operative complications and clinical efficacy at postoperative 6 months were observed. Preoperative and postoperative BMI, lipid level, glucose level and blood pressure were compared by t test.

LSG combined with LC was successfully performed in all patients. No evident complications, such as postoperative bleeding, gastric fistula, bile leakage, biliary tract injury and gastric cavity stenosis, were recorded during perioperative period. Preoperative body weight was (97±13) kg, which was decreased to (70±9) kg at postoperative 6 months. Preoperative BMI was (35.6±6.4) kg/m², which was declined to (23.2±1.3) kg/m² after surgery. In 28 patients with hyperlipidemia, preoperative lipid level was (12.8±7.5) mmol/L and decreased to (2.2±1.1) mmol/L after surgery. In 12 patients with type 2 diabetes mellitus, preoperative fasting glucose level was (12.5±1.7) mmol/L and decreased to (5.5±0.9) mmol/L postoperatively. In 10 patients with hypertension, preoperative blood pressure level was (168±13)/(104±9) mmHg and declined to (138±11)/(90±6) mmHg after surgery (1 mmHg=0.133 kPa)(t=8.641, 8.505, 31.272, 10.443, 8.862, 8.414; P<0.05).

It is safe and feasible to perform LSG combined with LC for obese patients complicated with cholecystolithiasis, which can remarkably mitigate metabolic diseases, such as obesity, hyperlipidemia, hypertension and hyperglycemia, etc. LSG combined with LC yields equivalent efficacy to that of LSG or LC alone, whereas it has advantages in alleviating trauma and lowering surgical cost, etc.