gastric bipass sergery

gastric bipass sergery ack aisee takneek koo sandarbhit karati haye jisamen pett koo ack chhoti oopari thaili aur ack bahut badee nichali "avashesh" thaili mein vibhajit kiya jaataa haye aur phir chhoti aant koo donon seey jodane key liye phir seey vyavasthit kiya jaataa haye. shalyachikitsakon ney aant koo phir seey jodane key kaee alag-alag tareeke vikasit kiye hain, iss prakaar kaee alag-alag gastric bipass prakriyaaen (jee. bee. pee.) hoti hain. kissy bhee jee. bee. pee. seey pett kii karyatmak matra mein ullekhaniya kamee aatee haye, jisake saath bhojan key liye ack parivartit shaaririk aur shaaririk pratikriya hoti haye.
operation koo rugna motape (40 seey adhik boddy maas index key roop mein paribhaashit), type 2 madhumeh, uchch raktchaap, sleep apania aur anya comorbid sthitiyon key ilaaj key liye nirdhaarit kiya jaataa haye. "bariatric sergery" shabd rugna motape key liye shalya chikitsa upchaar key "sabhi" koo shamil kartaa haye, naa kii kewal gastric bipass, joe iss tarah key sanchaalan kaa kewal ack varg banaate hain. parinamswarup vajan mein kamee, aamtaur parr naatakiya roop seey, commorbidity koo cumm curr detee haye. gastric bipass rogiyon kii deerghakaalik mrityu darr mein 40 pratishat taka kii kamee dikhaai gaee haye. sabhi shalya chikitsa key saath, jatilataaen hoe sakati hain. 2005 seey 2006 taka key ack adhyayan seey pataa chalaa kii 15 pratishat rogiyon ney gastric bipass key parinamswarup jatilataon kaa anubhav kiya, aur 0.5 pratishat rogiyon kii sergery key chhah maheene key bheetar jatilataon key kaaran mrityu hoe gaee. 2021 mein lancet mein prakaashit 174,772 pratibhagiyon key ack metaa-vishleshan mein paaya gayaa kii bariatric sergery type 2 madhumeh vaale yaa binaa motape seey grast vayaskon mein sabhi karanon seey mrityu darr mein kramshah 59 pratishat aur 30 pratishat kii kamee key saath judee thee. iss metaa-vishleshan mein yeh bhee paaya gayaa kii madhumeh seey peedit motey vayaskon key liye ausat jeevan-pratyasha 9.3 varsh adhik thee, jinhone niyamit (gair-shalya chikitsa) dekhbhal kii tulanaa mein bariatric sergery praapt kii thee, jabaki madhumeh key binaa motey vayaskon key liye jeevan pratyasha 5.1 varsh adhik thee.
upayog karein.
gastric bipass koo rugna motape key shalya chikitsa upchaar key liye ingit kiya jaataa haye, ack nidan joe taba kiya jaataa haye jaba rogi gambhir roop seey motaa hotaa haye, aahar prayason seey santoshjanak aur nirantar vajan ghataane mein asamarth hotaa haye, aur isamen aisee saha-rugna sthitiyaan hoti hain joe yaa tou jeevan key liye khatarnak hoti hain yaa jeevan kii gunavatta mein gambhir haani hoti haye.
1991 seey pahale, chikitsakon ney gambhir motape kii vyakhya "aadarsh shareer key vajan" seey cumm seey cumm adhik vajan key roop mein kii, ack beemakrit roop seey nirdhaarit shareer kaa vajan jiss parr jeevan-beema udyog dwara nirdhaarit sabse lambe samay taka jeene kii sambhavana thee. yeh mandand cumm qada key vyaktiyon key liye whiffle rhaa.
1991 mein, rashtriya swaasthya sansthaan (aine. aaee. aich.) ney ack sarvasammati panel koo praayojit kiya, jisaki sifaarishon ney shalya chikitsa upchaar, boddy maas index (bee. aim. aaee.) parr vichaar karane key liye maanak nirdhaarit kiya haye. bmi koo shareer key vajan (kilogram mein) key roop mein paribhaashit kiya gayaa haye, jise oonchaai key varg (meater mein) seey vibhajit kiya gayaa haye. parinam koo prati varg meater kilogram kii ikaaiyon mein ack sankhya key roop mein vyakt kiya jaataa haye. swasth vayaskon mein, bmi 18.5 seey 24.9 taka hotaa haye, jisamen 30 seey adhik bmi koo motapa maanaa jaataa haye, aur 18.5 seey cumm bmi koo cumm vajan maanaa jaataa haye.
rashtriya swaasthya sansthanon (aine. aaee. aich.) key sarvasammati panel ney gastric bipass prakriyaon sahit bariatric sergery parr vichaar karane key liye nimnalikhit maandandon kii sifarish keeh
sarvasammati panel ney sambandhit saha-rugnataon aur poshan, shaaririk gatividhi, vyavhaar aur manovaigyaanik jarooraton kaa prabandhan karane key liye chikitsakon aur chikitsakon kii ack team dwara bariatric shalya chikitsa rogi kii bahu-vishayak dekhbhal kii aavashyakta parr bhee jore diyaa. shalya chikitsa prakriya koo ack "upkaran" key roop mein sabse achchha maanaa jaataa haye joe rogi koo jeevan shally aur khaane kii aadton koo badalane mein saksham banaata haye, aur motape aur khaane key vyavhaar key prabhaavi aur sthaayi prabandhan koo praapt kartaa haye.
1991 key baad seey, bariatric sergery key kshetra mein pramukh vikas, vishesh roop seey laparoscopy, nih panel key kuchh nishkarshon koo purana curr diyaa haye. 2004 mein american society forr bariatric sergery (aeye. aiss. bee. aiss.) ney ack sarvasammati sammelan praayojit kiya jisane saboot aur nih panel key nishkarshon koo adyatan kiya. shalya chikitsa aur gair-shalya chikitsa donon vishayon key chikitsakon aur vaigyaanikon seey banaa yeh sammelan kaee nishkarshon parr pahuncha, jinamen shamil hainh
shalya chikitsa takneek.
gastric bipass, apane vibhinn roopon mein, kiye gaye bariatric shalya chikitsa prakriyaon key ack badey hisse key liye jimmedaar haye. yeh anuman lagaaya gayaa haye kii 2008 mein sanyukt raajya america mein 200,000 aise operation kiye gaye they.
laparoscopic sergery kaee chhote cheere, yaa "port" kaa upayog karke kii jaati haih ack video cameray seey judey cergical telescope koo daalane key liye, aur anya vishesh sanchaalan upkaranon taka pahunch kii anumati dene key liye. shalya chikitsak video screen parr operation koo dekhta haye. laparoscopy koo seemit abhigam shalya chikitsa bhee kahaa jaataa haye, joe ootakon koo sambhaalane aur mahsoos karane kii seema koo darshaata haye aur video chhavi key seemit sankalp aur dwi-ayami koo bhee darshaata haye. anubhav key saath, ack kushal laparoscopic sarjan adhikansh prakriyaon koo ack khule cheere key saath teji seey curr sakata haye-ack cheere kaa upayog karane key vikalp key saath aavashyakta utpann honey parr.
rooks-aine-vaaee laparoscopic gastric bipass, jise pahale 1993-1994 key beach cases studdy mein pradarshan kiya gayaa aur report kiya gayaa, seemit pahunch takneekon dwara pradarshan karane key liye sabse kathin prakriyaon mein seey ack maanaa jaataa haye. iss vidhi key upayog ney sambandhit laabhon key kaaran operation koo bahut lokpriya banaa diyaa haye jaise kih aspatal mein rehna cumm karna, cumm asuvidha, cumm swaasthya laabh kaa samay, cumm nishan aur incitional hernia kaa nyuntam jokhim.
aavashyak visheshataaen.
gastric bipass prakriya mein shamil hainh
vividhataaen.
gastric bipass, rocks-aine-vaaee (aar. aaee. jee. bee., proximal).
yeh sanskaran sabse adhik upayog kii jaane vaali gastric bipass takneek haye, aur sanyukt raajya mein abb taka kii sabse adhik kii jaane vaali bariatric prakriya haye. chhoti aant koo nichale pett key nikas key lagbhag neeche vibhajit kiya jaataa haye aur ise ack vaaee-vinyas mein phir seey vyavasthit kiya jaataa haye, jisase ack "rocks limb" key madhyam seey chhote oopari pett kii thaili seey bhojan kaa bahirgaman sambhav hoe jaataa haye. sameepavarti sanskaran mein, vaaee-anuchhedan chhoti aant key oopari (sameepavarti) chhor key paas banata haye. rokes anga kaa nirmaan chhoti aant kaa upayog karke kiya jaataa haye, joe isake baaki (aur adhikansh) poshak tatvon koo avashoshit karane seey bachaata haye. rogi koo bhojan shuru honey key turant baad pett bharaa huaa mahsoos honey kii bahut teji seey shuruat kaa anubhav hoga, jisake baad badhati tripti (yaa bhojan key prati "udasinta") hogi.
gastric bipass, rocks-aine-vaaee (aar. aaee. jee. bee., distal).
chhoti aant aam taur parr lambai mein hoti haye. jaise-jaise vaaee-connection koo jathrantra path key neeche aage badhaaya jaataa haye, poshak tatvon koo poori tarah seey avashoshit karane key liye upalabdh raashi uttarottar cumm hoe jaati haye, operation kii adhik prabhavsheelta key liye vyaapaar kiya jaataa haye. vaaee-connection chhoti aant key nichale (door) chhor key bahut karib banata haye, aamtaur parr nichale chhor seey, jisase bhojan kaa avashoshan (apashoshan) cumm hoe jaataa haih mukhya roop seey vasaa aur starch, lekin vibhinn khanijon aur vasaa-ghulansheel vitaminon kaa bhee. avashoshit vasaa aur starch badee aant mein jaate hain, jahan bacteria kii kriyaaen una parr jalan aur durbhavanapurna gasses kaa utpaadan karane key liye kaary curr sakati hain. poshan parr inn badey prabhaavon kaa kull vajan ghataane mein apekshaakrit mamuli vriddhi key liye vyaapaar kiya jaataa haye.
mini-gastric bipass (aim. jee. bee.).
mini-gastric bipass prakriya koo pahali baar 1997 mein america key robbert rutleys dwara maanak bilroth II prakriya key sanshodhan key roop mein vikasit kiya gayaa thaa. ack mini gastric bipass apani dahini seema (cumm vakrata) key saath pett kii ack lambi sankeern nully banaata haye. chhoti aant kaa ack loop oopar laaya jaataa haye aur aant kii shuruat seey lagbhag 180 semi parr iss nully seey judaa hotaa haye.
kaee adhyayanon seey pataa chalata haye kii loop punarnirmaan (bilroth II gastrogeunostomy) pett parr cumm rakhane parr adhik surakshit roop seey kaam kartaa haye, lekin annapranali key buggle mein rakhane parr ack aapada hoe sakati haye. aaj hajaaron "loops" kaa upayog shalya chikitsa prakriyaon key liye kiya jaataa haye taaki alsar, pett key cancer aur pett mein chot jaisi gastric samasyaon kaa ilaaj kiya jaa sakey. mini-gastric bipass low sett loop punarnirmaan kaa upayog kartaa haye aur iss prakaar pitt reflux kii durlabh sambhavana haye.
aim. jee. bee. koo isake nirmaan kii saralata key kaaran rocks-aine-vaaee prakriya key vikalp key roop mein sujhaaya gayaa haye aur jatilataon key cumm jokhim aur achche nirantar vajan ghataane key kaaran adhik seey adhik lokpriya hoe rhaa haye. yeh anuman lagaaya gayaa haye kii asia mein vajan ghataane kii sergery kaa 15.4% abb mgb takneek key madhyam seey kiya jaataa haye.
endoscopic duodenal-jejunal bipass.
iss takneek parr 2000 key dashak key madhya seey naidaanik roop seey shodh kiya jaa rhaa haye. isamen duodenum (pett seey chhoti aant kaa pahala hissa) aur madhya-jejunam (chhoti aant kaa maadhyamik charan) key beach ack duodenal-jejunal bipass liner kaa pratyaropan shamil haye. yeh aanshik roop seey pachane vaale bhojan koo chhoti aant key maadhyamik charan key pahale aur praarambhik bhaag mein pravesh karane seey rokta haye, joe rocks-aine-vaaee gastric bipass (aar. aaee. jee. bee.) sergery key billiopancratic hisse key prabhaavon kii nakal kartaa haye. gastroentestinal raktasraav, pett dard aur upkaran pravaas jaisi kuchh gambhir pratikool ghatnaaon key bavjood-sabhi upkaran hataane key saath hull kiye gaye-praarambhik naidaanik parikshanon ney vajan ghataane aur glucose homeostasis parinamon mein sudhaar karane kii upchaar kii kshamata mein ashajanak parinam utpann kiye hain.
shareer vigyaan.
gastric bipass seey pett kaa aakar 90 pratishat seey adhik cumm hoe jaataa haye. ack samanya pett kabhi-kabhi 1000 millie seey adhik taka fail sakata haye, jabaki gastric bipass kii thaili aakar mein 15 millie hoe sakati haye. gastric bipass pouch aamtaur parr pett key usa hisse seey banati haye joe khinchaav key liye sabse cumm atisamvedansheel hotaa haye. kii, aur iska chhota mool aakar, thaili kii matra mein kissy bhee mahatvapurna deerghakaalik parivartan koo rokta haye. samay key saath joe badalata haye, vaha haye pett aur aant key beach sambandh kaa aakar aur chhoti aant kii adhik matra mein bhojan rakhane kii kshamata. samay key saath, thaili kii karyatmak kshamata badh jaati haye; usa samay taka, vajan cumm hoe gayaa haye, aur badhee hui kshamata koo cumm shareer key vajan key rakharkhaav kii anumati dene key liye kaam karna chaahiye.
jaba rogi kewal thodi matra mein bhojan khaata haye, tou pahali pratikriya pett kii thaili kii deewaar kaa khinchaav haye, joe mastishk koo bataati haye kii pett bharaa huaa haye. rogi koo paripoornata kii anubhooti hoti haye, jaise kii unhone abhee-abhee ack badaa bhojan khaaya thaa-lekin kewal ack chhote seey bhojan key saath. adhikansh loga kewal poornata kii bhavna key jawab mein khaana bund naheen karate hain, lekin rogi koo teji seey pataa chalata haye kii baad key kaatane koo bahut dheere-dheere aur savdhani seey khaaya jaanaa chaahiye, taaki badhati asuvidha yaa ulti seey bachaa jaa sakey.
chhoti aant mein jaane seey pahale bhojan koo sabse pahale pett mein manthan kiya jaataa haye. jaba chhoti aant kaa lumen poshak tatvon key sampark mein aataa haye, tou kaee harmon jaari kiye jaate hain, jinamen duodenum seey colesistokinin aur paai aur iliyam seey glp-1 shamil hain. yeye harmon aage key bhojan key sevan koo rokte hain aur iss prakaar inhen "tript kaarak" kahaa gayaa haye. "ghrelin" ack harmon haye joe pett mein nikalata haye joe bhookh aur bhojan key sevan koo uttejit kartaa haye. gastric bipass key baad harmon key star mein parivartan kii parikalpana kii gaee haye kii motey rogiyon mein bhojan key sevan aur shareer key vajan mein kamee aatee haye. haalaanki, yeye nishkarsh vivadaspad baney hue hain, aur jiss sateek tantra dwara gastric bipass sergery bhojan key sevan koo cumm karati haye aur shareer key vajan koo abhee taka spasht naheen kiya gayaa haye.
udaaharan key liye, yeh abhee bhee vyaapak roop seey maanaa jaataa haye kii gastric bipass yaantrik madhyam seey kaam kartaa haye, i.ee. khaadya pratibandh aur/yaa apashoshan. haalaanki, haal key naidaanik aur pashu adhyayanon ney sanket diyaa haye kii rocks-aine-vaaee gastric bipass (aar. aaee. jee. bee.) key tantra key baare mein yeye lambe samay seey chaley aaa rahey nishkarsh sahee naheen hoe sakate hain. saakshyon key badhate shareer seey pataa chalata haye kii rygb key parinamswarup shareer key vajan aur chayapachaya mein gahan parivartanon koo saral yaantrik pratibandh yaa avashoshan dwara samajhaaya naheen jaa sakata haye. choohon mein kiye gaye ack adhyayan mein paaya gayaa kii raigb ney kull 19 pratishat kii vriddhi aur aaraam karane key oorjaa kharch mein 31 pratishat kii vriddhi koo prerit kiya, ack prabhaav joe urdhvaadhar baju key gastractomy choohon mein pradarshit naheen huaa. isake alawa, jode seey poshit choohon ney apane rigby samkakshon kii tulanaa mein kewal 47 pratishat adhik vajan cumm kiya. aar. aaee. jee. bee. key baad bhojan key sevan mein parivartan kewal aanshik roop seey aar. aaee. jee. bee.-prerit vajan ghataane key liye jimmedaar haye, aur vajan ghataane mein yogdan karane vaali calori key naidaanik roop seey mahatvapurna avashoshan kaa koee saboot naheen haye. iss prakaar, yeh prateet hotaa haye kii rygb saral yaantrik pratibandh yaa avashoshan key bajaay vajan viniyaman aur khaane key vyavhaar key shareer vigyaan mein badalaav karke vajan ghataane koo prabhaavit kartaa haye.
iss shareer vigyaan seey adhikatam laabh praapt karane key liye, yeh mahatvapurna haye kii rogi kewal bhojan key samay, pratidin 5 seey 6 chhote bhojan karey, aur bhojan key beach "naheen" charata haye. dainik protein key 80-100 g praapt karane parr dhyaan kendrit karna aavashyak haye. shalya chikitsa key baad bhojan-cup, dheere-dheere ack saal taka 1 cup taka pahunch jaataa haye. isake liye khaane key vyavhaar mein badalaav aur bhojan khojane key liye lambe samay seey praapt aadton mein badalaav kii aavashyakta hoti haye. lagbhag harr mamle mein jahaan shalya chikitsa key baad dair seey vajan badhata haye, bhojan kii kshamata mein bahut adhik vriddhi naheen hui haye. kuchh loga maanate hain kii vajan phir seey badhane kaa kaaran rogi kii galati honey chaahiye, jaise.jee. uchch calori vaale snack khaadya padarthon key saath bhojan key beach khaana, halanki iss parr bahas hui haye. anya logon kaa maanana haye kii yeh kuchh rogiyon key liye shalya chikitsa kii ack apratyaashit viphalata yaa seema haye (jaise.jee. pratikriyaasheel hypoglycemia).
jatilataaen.
kissy bhee badee shalya chikitsa mein jatilataon kii sambhavana shamil hoti haye-pratikool ghatanaaen joe jokhim, aspatal mein rahane aur mrityu darr koo badhaati hain. kuchh jatilataaen pett key sabhi operations key liye aam hain, jabaki kuchh bariatric sergery key liye vishisht hain.
mrityu darr aur jatilata darr.
shalya chikitsa key baad 30 dinon key dauran jatilataon kii samagr darr laparoscopic prakriyaon key liye 7 pratishat seey laker khule cheere key madhyam seey sanchaalan key liye 14.5% taka hoti haye. mrityu darr parr ack adhyayan seey pataa chalaa kii 401 laparoscopic mamalon mein seey 0 pratishat mrityu darr aur 955 khuli prakriyaon mein seey 0.6 pratishat. samaan mrityu darr-30-divasiya mrityu darr 0.11%, aur 90-divasiya mrityu darr 0.3%-yuu. mein darj kii gaee haye.aiss. utkrishtata karyakram key kendra, 106 kendron parr 33,117 sanchaalan key parinam hain.
mrityu darr aur jatilataaen pahale seey maujood jokhim karakon jaise motape kii degree, hriday roga, avarodhak sleep apania, madhumeh melitus aur poorv fuffusiya ambolism key itihas seey prabhaavit hoti hain. yeh shalya chikitsak key anubhav seey bhee prabhaavit hotaa haih laparoscopic bariatric sergery key liye seekhane kii avastha lagbhag 100 mamalon kaa anuman haye. sarjan kaa chayan karate samay paryavekshan aur anubhav mahatvapurna hotey hain, kyonki jiss tarah seey ack sarjan samasyaon seey nipatane mein anubhavi hotaa haye, vaha unakaa saamana karna aur unhein hull karna hotaa haye.
pett kii shalya chikitsa kii jatilataaen.
sankraman.
operation key dauran aantr seey bacteria key nikalane key kaaran cheere yaa pett key ander kaa sankraman (peritonitis, fodaa) hoe sakata haye. pneumonia, mootrashay yaa gurde key sankraman jaise nosocomial sankraman aur sepsis (rakt janit sankraman) bhee sambhav hain. antibiotic davaaon kaa prabhaavi alpakaalik upayog, mehnati shwasan chikitsa, aur shalya chikitsa key baad kuchh ghanton key bheetar gatividhi koo protsaahit karane seey sankraman key jokhim koo cumm kiya jaa sakata haye.
shiraparak thromboembolism.
shalya chikitsa jaisi koee bhee chot, shareer mein rakt key jamaavat koo badhaane kaa kaaran banati haye. saath hii, gatividhi cumm kii jaa sakati haye.
gastric bipass sergery nyuntam aakramak takneekon (laparoscopy) key saath kii jaati haye. shalya chikitsa key liye see. oh. 2 key saath pett kii guha key soojan key kaaran shiraparak vaapsee cumm hoe jaati haye aur isase nichale chhoron kii gahari nus ghanastrata hoe jaayegi.pairon kii nason mein, yaa kabhi-kabhi shroni mein, vishesh roop seey rugna roop seey motey rogi mein thakke banane kii sambhavana badh jaati haye. ack thakka joe mukt hoe jaataa haye aur fefadon mein tairta haye, usey fuffusiya ambolus kahaa jaataa haye, joe ack bahut hii khatarnak ghatana haye. iss prakaar kii jatilata kii sambhavana koo cumm karane key liye aamtaur parr sergery seey pahale rakt koo patala karane vaale koo diyaa jaataa haye.
raktasraav.
pett koo vibhajit karane aur aantr koo sthanantarit karane key liye kaee rakt vaahikaon koo kaataa jaanaa chaahiye. inmein seey kissy bhee raktasraav koo baad mein shuru kiya jaa sakata haye, yaa tou pett mein (pett key bheetar raktasraav) yaa aantr mein hii (jathrantra raktasraav). aadhaan kii aavashyakta hoe sakati haye, aur kabhi-kabhi punah-operation kii aavashyakta hoti haye. shiraparak thromboembolic roga koo rokane key liye rakt koo patala karane vaale kaa upayog vaastav mein raktasraav key jokhim koo thodaa badhaa sakata haye.
hernia.
hernia ack asamanya chhidra haye, yaa tou pett key bheetar yaa pett kii deewaar kii maanspeshiyon key madhyam seey. ack aantarik hernia shalya chikitsa aur aantr kii punah vyavastha key parinamswarup hoe sakata haye aur aantr baadha kaa kaaran haye. anticolic antigastric rocks-aine-vaaee gastric bipass sergery key parinamswarup 0.20% mamalon mein aantarik hernia honey kaa anuman lagaaya gayaa haye, mukhya roop seey pieterson key dosh key madhyam seey. ack incitional hernia taba hotaa haye jaba ack cergical cheera achchi tarah seey thheek naheen hotaa haye; pett kii maanspeshiyaan alag hoe jaati hain aur ack thaili jaisi jhilli key baahar nikalane kii anumati detee hain, jisamen aantr yaa anya pett kii samagri hoe sakati haye, aur joe dardanaak aur bhadde hoe sakate hain. laparoscopic sergery mein pett kii deewaar key andakosh kaa khatra kaafee cumm hoe jaataa haye.
aantr avrodh.
pett kii shalya chikitsa key parinamswarup hamesha aantr parr kuchh nishan parh jaate hain, jinhen asanjan kahaa jaataa haye. ack hernia, yaa tou aantarik yaa pett kii deewaar key madhyam seey, bhee hoe sakata haye. jaba aantr asanjan yaa hernia seey funce jaataa haye, tou yeh mool prakriya key kaee saal baad kabhi-kabhi kanghi aur baadhit hoe sakata haye. iss samasya koo thheek karane key liye aamtaur parr ack operation aavashyak hotaa haye.
gastric bipass kii jatilataaen.
anastomotic risaav.
anastomosis pett aur aantr key beach yaa aantr key dou hisson key beach ack shalya chikitsa sambandh haye. shalya chikitsak dou angon koo yaa tou mukhya yaa taanke seey jodkar ack jall-tanga sambandh banaane kaa prayaas kartaa haye, jinamen seey koee bhee vaastav mein aantr kii deewaar mein ack chhed banaata haye. shalya chikitsak shareer kii praakritik upchaar kshamataon aur ack swa-sealing tyre kii tarah ack muhar banaane kii isaki kshamata parr bharosa karega, taaki shalya chikitsa mein safal hoe sakey. yadi vaha muhar kissy bhee kaaran seey banane mein whiffle rahati haye, tou jathrantra path key bheetar seey taral padaarth sterile pett guha mein ris sakata haye aur sankraman aur phode key gathan koo janm dey sakata haye. anastomosis kaa risaav lagbhag 2 pratishat rocks-aine-vaaee gastric bipass mein aur 1 pratishat seey cumm mini gastric bipass mein hoe sakata haye. risaav aamtaur parr pett-aant sambandh (gastro-jejunostomy) mein hotaa haye.
anastomotic sakht.
anastomosis key thheek honey parr, yeh nishan ootak banaata haye, joe samay key saath swabhavik roop seey sikud jaataa haye ("anubandh"), jisase udghaatan chhota hoe jaataa haye. ise "sakht" kahaa jaataa haye. aamtaur parr, ack anastomosis key madhyam seey bhojan kaa maarg ise khula rakhega, lekin yadi soojan aur upchaar prakriya khinchaav prakriya koo baahar curr detee haye, tou nishan dwaar koo itna chhota banaa sakate hain kii taral padaarth bhee abb isake madhyam seey naheen gujar sakate hain. samadhan ack prakriya haye jise gastro endoscopy kahaa jaataa haye, aur isake ander ack gubbare koo phulaakar connection koo failaaya jaataa haye. kabhi-kabhi iss herfer koo sthaayi sudhaar praapt karane key liye ack seey adhik baar karna parh sakata haye.
anastomotic alsar.
anastomosis kaa alsar rogiyon key 1-16% mein hotaa haye. aise alsar key sambhaavit kaaran hainh
iss sthiti kaa ilaaj iss prakaar kiya jaa sakata haih
dumping syndrome.
aam taur parr, pett key nichale chhor parr piloric valve bhojan koo aantr mein chhodane koo niyantrit kartaa haye. jaba gastric bipass rogi ack meethaa bhojan khaata haye, tou cheeni teji seey aant mein chully jaati haye, jahaan yeh dumping syndrome naamak shaaririk pratikriya koo janm detee haye. shareer sharkara koo kamjor karane key prayaas mein aanton mein gastric samagri bhar dega. ack prabhaavit vyakti apane dill kii dhadkan koo teji seey aur balpurvak mahsoos curr sakata haye, thhande paseene mein toot sakata haye, pett mein titliyon kaa ehsas hoe sakata haye, aur usey chinta kaa daura parh sakata haye. vyakti koo aamtaur parr letna padata haye aur vaha 30-45 minaton key liye bahut asahaj hoe sakata haye. isake baad dast hoe sakata haye.
poshan sambandhi kamiyaan.
gastric bipass sergery key baad poshan sambandhi kamiyaan aam hain, aur aksar pahachaani naheen jaati hain. inmein shamil hainh
poshan prabhaav.
shalya chikitsa key baad, rogi kewal thodi matra mein bhojan karane key baad paripoornata mahsoos karate hain, jisake baad jald hii triptata aur bhookh kii kamee kii bhavna hoti haye. kull bhojan kaa sevan ullekhaniya roop seey cumm hoe gayaa haye. nae banaae gaye pett kii thaili key aakar mein kamee aur bhojan kaa sevan cumm honey key kaaran, paryaapt poshan kii maang haye kii rogi bhojan key sevan key liye sarjan key nirdeshon kaa paalan karey, jisamen dainik bhojan kii sankhya, paryaapt protein kaa sevan aur vitamin aur khanij poorak kaa upayog shamil haye. calcium supplement, iron supplement, protein supplement, multy-vitamin (kabhi-kabhi prasav poorv vitamin sabse achche hotey hain), aur vitamin koo (sinocobalamine) supplement sabhi operation key baad key rogi key liye bahut mahatvapurna hain.
gastric bipass sergery key baad bhojan kaa kull sevan aur avashoshan darr teji seey cumm hoe jaayegi, aur pett mein acid paida karane vaali koshikaon kii sankhya badh jaayegi. uchch amlata key star kaa mukabala karane key liye doctor aksar aml-cumm karane vaali davaayen likhate hain. kaee rogiyon koo taba ack aisee sthiti kaa anubhav hotaa haye jise chlorhydria key roop mein jaanaa jaataa haye, jahan pett mein paryaapt acid naheen hotaa haye. cumm amlata key star key parinamswarup, rogiyon mein bacteria kaa adhik vikas hoe sakata haye. 43 shalya chikitsa key baad key rogiyon parr kiye gaye ack adhyayan seey pataa chalaa kii lagbhag sabhi rogiyon ney hydrogen shwas pareekshan key liye sakaratmak pareekshan kiya, joe chhoti aant mein bacteria key atee vikas kaa sanket detaa haye. jivaanuon key adhik badhane seey aanton kii paaristhitiki badal jaati haye aur matali aur ulti hoti haye. baar-baar honey vaali matali aur ulti antatah bhojan key avashoshan darr koo badal detee haye, joe operation key baad gastric bipass rogiyon mein aam vitamin aur poshan kii kamee mein yogdan detee haye.
protein poshan.
protein aavashyak khaadya padaarth hain, joe maans, machhali, murgi paalan, dayeri utpaad, andey, sabjiyan, phal, faliyaan aur meve jaise khaadya padarthon mein nihit hotey hain. badee matra mein bhojan karane kii kshamata cumm honey parr, gastric bipass rogiyon koo pahale apani protein aavashyaktaon koo khaane parr dhyaan kendrit karna chaahiye, aur pratyek bhojan key saath. kuchh mamalon mein, shalya chikitsak taral protein poorak key upayog kii sifarish curr sakate hain. smoodi yaa kissy bhee bhojan mein jode gaye protein key pouder poorak post-opp aahar kaa ack mahatvapurna hissa hoe sakate hain.
calori poshan.
bariatric sergery key baad honey vaalaa gahara vajan ghataana shareer koo harr dinn upayog karane kii aavashyakta kii tulanaa mein bahut cumm oorjaa (calori) lene key kaaran hotaa haye. kamee kii bharpai karane key liye vasaa ootak koo jalaaya jaanaa chaahiye, aur vajan ghataane key parinam. antatah, jaise-jaise shareer chhota hotaa jaataa haye, isaki oorjaa kii aavashyakta cumm hoe jaati haye, jabaki rogi koo ack saath kuchh adhik bhojan karna sambhav lagata haye. jaba oorjaa kaa sevan khaane vaali calori key barabar hoga, tou vajan cumm honah bund hoe jaayega. proximal jee. bee. pee. key parinamswarup aamtaur parr shareer kaa atirikt vajan 60-80% cumm hoe jaataa haye, aur bahut cumm hii atyadhik vajan cumm hotaa haye. distal jee. bee. pee. key saath atyadhik vajan ghataane kaa khatra thodaa adhik hotaa haye.
vitamin.
vitamin aamtaur parr khaadya padarthon aur poorak padarthon mein nihit hotey hain. jee. bee. pee. key baad khaae jaane vaale bhojan kii matra gambhir roop seey cumm hoe jaati haye, aur vitamin kii matra tadnusar cumm hoe jaati haye. isaliye sabhi vitamin aur khanijon kii nyuntam dainik aavashyaktaon koo puuraa karane key liye poorak aahar liya jaanaa chaahiye. prasav-poorv vitaminon kaa sujhaav kabhi-kabhi doctors dwara diyaa jaataa haye, kyonki unamen adhikansh bahu-vitaminon kii tulanaa mein kuchh vitamin adhik hotey hain. adhikansh vitaminon kaa avashoshan nikatvarti jee. bee. pee. key baad gambhir roop seey prabhaavit naheen hotaa haye, halanki vitamin koo kuchh vyaktiyon mein achchi tarah seey avashoshit naheen hoe sakata haih koo kii upabhaashiya taiyari paryaapt avashoshan pradaan karati haye. kuchh adhyayanon seey pataa chalata haye kii sergery key baad probiotics lene vaale jee. bee. pee. rogi sergery key baad probiotics naheen lene vaale rogiyon kii tulanaa mein koo kii adhik matra koo avashoshit karane aur banaae rakhane mein saksham hotey hain. door taka jee. bee. pee. key baad, vasaa mein ghulansheel vitamin aeye, dee aur ee achchi tarah seey avashoshit naheen hoe sakate hain, khaskar yadi vasaa kaa sevan adhik haye. inn vitaminon key jall-vikshipt roopon koo vishisht chikitsak kii sifarish parr ingit kiya jaa sakata haye. kuchh rogiyon key liye, upa-bhashai koo paryaapt naheen haye, aur rogiyon koo koo injection kii aavashyakta hoe sakati haye.
khanij.
jee. bee. pee. key sabhi sanskaran duodenum koo darkinar karate hain, joe loha aur calcium donon key avashoshan kaa praathamik sthal haye. masik dharm aaney vaali mahilaaon mein iron pratisthaapan aavashyak haye, aur sabhi rogiyon mein iron aur calcium kaa poorak honah behtar haye. lauh sulfate koo kharaab tareeke seey sahan kiya jaataa haye. lohe key vaikalpik roop (fumourate, gluconet, chillets) cumm pareshan karane vaale hotey hain aur shayed behtar avashoshit hotey hain. calcium "carbonate" kii taiyari seey bhee bachana chaahiye; citrate key roop mein calcium yaa gluconet (1200 milligram calcium key saath) mein pett mein acid seey swatantra adhik jaiv upalabdhata hoti haye, aur sambhavatah behtar avashoshit hoe jaayegi. kabhi-kabhi doctors dwara calcium praapt karane key liye ack achche tareeke key roop mein chabaa jaane yogya calcium poorak jinamen vitamin key shamil hotaa haye, kii sifarish kii jaati haye.
sharaab chayapachaya.
shalya chikitsa key baad gastric bipass rogiyon mein maadak peya padarthon key liye cumm sahishnuta vikasit hoti haye kyonki unakaa parivartit paachan tantra una logon kii tulanaa mein teji seey sharaab koo avashoshit kartaa haye jinhone shalya chikitsa naheen kii haye. shalya chikitsa key baad rogi koo sharaab peene key baad shaant star taka pahunchane mein bhee adhik samay lagata haye. 36 post-operative rogiyon aur 36 vishayon key ack niyantran samooh (jinhone sergery naheen kii thee) parr kiye gaye ack adhyayan mein, pratyek vishay ney 5 auns piyaa. redd wine kaa gillas aur sharaab chayapachaya kaa mulyankan karane key liye unaki saans mein sharaab koo maapa gayaa thaa. gastric bipass samooh mein ausat charam sharaab saans kaa star 0.08% thaa, jabaki niyantran samooh mein ausat charam sharaab saans kaa star 0.05% thaa. gastric bipass rogiyon key samooh koo shoonya kii sharaab kii saans parr lautane mein ausatan 108 minut lagey, jabaki niyantran samooh koo ausatan 72 minut lagey.
pica.
aise mamle saamane aae hain jinamen vikaar key poorv-shalya itihas vaale rogiyon mein gastric bipass key baad pica kii punaravritti hoti haye, joe sambhavatah iron kii kamee key kaaran hotey hain. pica samanya bhojan key alawa anya padaarth khaane kii ack badhyakari pravritti haye. kuchh udaaharan loga kagaj, mitty, plaster, raakh yaa burf khaate hain. jinn rogiyon ney gastric bipass kiya haye, unamen iron aur haemoglobin kaa nimn star aam haye. ack adhyayan mein ack mahila post-operative gastric bipass rogi parr report kiya gayaa joe aathh seey duss 32 auns khaa rahee thee. ack dinn mein burf kaa chashma. rogi key rakt pareekshan mein 2.3 mimeol/ell key iron key star aur 5.83 mimeol/ell key haemoglobin key star kaa pataa chalaa. vayask mahilaaon key samanya rakt mein iron kaa star 30 seey 126 microgram/dee. ell. hotaa haye aur samanya haemoglobin kaa star 12.1 seey 15.1 graam/dee. ell. hotaa haye. rogi key iron key star mein iss kamee key kaaran pica gatividhi mein vriddhi hoe sakati haye. rogi koo taba iron supplement diyaa gayaa joe usake haemoglobin aur iron key rakt key star koo samanya star parr leey aaya. ack maheene key baad, rogi kaa khaana prati dinn dou seey teen gillas burf taka cumm hoe gayaa. iron supplement lene key ack saal baad rogi key iron aur haemoglobin kaa star samanya star parr banaa rhaa aur rogi ney bataaya kii usey burf key liye koee aur lalsa naheen thee.
gastric bipass key parinam aur swaasthya laabh.
shareer key atirikt vajan kaa 65-80% vajan cumm honah gastric bipass operation kii adhikansh badee shrinkhala kii visheshta haye. chikitsakiya roop seey adhik mahatvapurna prabhaavon mein comorbid sthitiyon mein naatakiya kamee shamil haih
 isake alawa, pree-diabetes key rogiyon mein type 2 madhumeh koo 30 gunaa seey adhik baar rokaa jaataa haye. inn sabhi nishkarshon kii soochana sabse pahale walter poriyon aur jose aff dwara dee gaee thee. kaaro.
2010 key motey rogiyon key ack badey sambhaavit adhyayan mein ack adhyayan mein 2037 rogiyon key gair-shalya chikitsa upchaar samooh kii tulanaa mein shalya chikitsa key baad 15 varshon taka mrityu darr mein 29 pratishat kii kamee (ling, ayu aur jokhim karakon key liye samaayojit honey parr jokhim anupaat 0.71) dikhaai gaee. 2021 mein lancet mein prakaashit 174772 pratibhagiyon key ack metaa-vishleshan mein paaya gayaa kii bariatric sergery type 2 madhumeh vaale yaa binaa motape seey grast vayaskon mein sabhi karanon seey mrityu darr mein kramshah 59 pratishat aur 30 pratishat kii kamee key saath judee thee. iss metaa-vishleshan mein yeh bhee paaya gayaa kii madhumeh seey peedit motey vayaskon key liye ausat jeevan-pratyasha 9.3 varsh adhik thee, jinhone niyamit (gair-shalya chikitsa) dekhbhal kii tulanaa mein bariatric sergery praapt kii thee, jabaki madhumeh key binaa motey vayaskon key liye jeevan pratyasha 5.1 varsh adhik thee.
saath hii, adhikansh rogi parivarik aur samajik gatividhiyon mein adhik bhagidari kaa anand lene mein saksham hotey hain.
gastric bipass kii laagat.
rogi kii jeb seey baahar kii laagat bhugtan kii vidhi, kshetra, shalya chikitsa abhyaas aur aspatal key aadhar parr vyaapak roop seey bhinn hoti haye jisamen prakriya kii jaati haye.
sanyukt raajya america mein bhugtan key tarikon mein niji beema, jaise kii vyaktigat aur parivarik coverage, ack niyokta key madhyam seey chhote samooh coverage (50 purnakaalik karmchaariyon key tahat) aur ack niyokta (50 yaa adhik purnakaalik karmchaariyon) key madhyam seey badey samooh coverage, saarvajanik beema (chikitsa aur chikitsa) aur swa-bhugtan shamil hain. niji yaa saarvajanik beema vaale rogi key liye jeb seey baahar kii laagat joe vishesh roop seey ack cover laabh key roop mein bariatric sergery koo soochibaddh karati haye, mein kaee beema-neeti-vishisht mapdand jaise katauti yogya star, saha-beema pratishat, saha-bhugtan raashi aur jeb seey baahar kii seema shamil hain.
binaa beema key rogiyon koo seedhe (yaa kissy teesare paksh key rinadaata key madhyam seey) shalya chikitsa key liye bhugtan karna hoga, aur kull laagat unake dwara chune gaye shalya chikitsa abhyaas aur usa aspatal parr nirbhar karegi jisamen shalya chikitsa prakriya prakriya karati haye. ausatan, sanyukt raajya america mein gastric bipass sergery kii kull laagat lagbhag $24,000 haye, halanki raajya-vishisht star parr yeh ausatan $15,000 (arconsus) seey laker ausatan $57,000 (alaska) taka haye.
germany mein ack gastric bipass operation, yadi swaasthya beema dwara cover naheen kiya jaataa haye aur isaliye niji taur parr bhugtan kiya jaataa haye, tou isaki laagat 15,000 euro taka hoti haye; switzerland mein chf 20,000-25,000, polland mein gastric bipass kii laagat lagbhag 4,000 pound haye, jabaki turkey mein isaki laagat 3,200 pound haye.
gastric bipass key saath rehna.
gastric bipass sergery kaa vyakti parr bhaavnaatmak aur shaaririk prabhaav padata haye. jinn logon ney shalya chikitsa karaai haye, unamen seey kaee logon mein agale maheenon mein avasaad vikasit hotaa haye, joe unake bhaavnaatmak kalyan mein bhojan kii bhoomika mein badalaav key parinamswarup hotaa haye. aahar parr sakht seemaaen rogi parr bahut bhaavnaatmak dabaav daal sakati hain. shalya chikitsa key baad kii avadhi mein oorjaa kaa star cumm hoe sakata haye, donon bhojan key sevan key pratibandh aur bhaavnaatmak sthiti mein nakaratmak parivartanon key kaaran. bhaavnaatmak staron koo palatane mein teen maheene taka kaa samay lugg sakata haye.
shalya chikitsa key baad key maheenon mein maanspeshiyon kii kamjori bhee aam haye. yeh kaee karakon key kaaran hotaa haye, jisamen protein key sevan parr pratibandh, maanspeshiyon key dravyamaan mein nuksan aur oorjaa key star mein girawat shamil haye. maanspeshiyon kii kamjori key parinamswarup santulan kii samasyaaen, seedhiyaan chadhane yaa bhaari vastuon koo uthaane mein kathinaaee hoe sakati haye, aur saral shaaririk karyon key baad thakan badh sakati haye. inmein seey kaee mudde samay key saath beet jaate hain kyonki bhojan kaa sevan dheere-dheere badhata haye. haalaanki, shalya chikitsa key baad key pahale maheene bahut kathin hoe sakate hain, ack aisee samasya jiska ullekh aksar shalya chikitsa kaa sujhaav dene vaale chikitsakon dwara naheen kiya jaataa haye. iss shalya chikitsa key laabh aur jokhim achchi tarah seey sthaapit hain; haalaanki, manovaigyaanik prabhaavon koo achchi tarah seey samajha naheen gayaa haye.
aggar shaaririk gatividhi mein vriddhi bhee hoe jaati haye, tou bhee rogi atirikt twacha aur vasaa key kaaran deerghakaalik manovaigyaanik prabhaavon koo janm dey sakate hain. aksar bipass sergery key baad twacha kii "boddy lift" aur vasaa jamaa key liposuction key saath kiya jaataa haye. inn atirikt shalya chikitsaon key apane antarnihit jokhim hotey hain lekin jaba samanya poshan sambandhi kamee key saath jodd diyaa jaataa haye joe gastric bipass rogiyon koo thheek karane key saath hoti haye tou yeye aur bhee khatarnak hoti hain.
sarjan maanyata.
american society forr metabolic aind bariatric sergery apane "center off axilance" network mein bariatric karyakramon aur sarjanon koo soochibaddh karati haye, jabaki american college off sarjan apane bariatric sergery center network key madhyam seey pradaataon koo maanyata detaa haye. anya deshon mein shalyachikitsakon aur kendron kii soochi key liye, motape aur chayapachaya vikaaron kii shalya chikitsa key liye antarrashtriya mahasangh desh dwara chikitsa sanghon koo soochibaddh kartaa haye.

