关键词: 代谢综合征, 胃切除术, 克氏针

Abstract: Objective To explore the feasibility and safety of using Kirschner wire and suture to block the liver in laparoscopic sleeve gastrectomy, and to improve the use of Kirschner wire. 
Methods A total of 88 patients with metabolic syndrome undergoing laparoscopic sleeve gastrectomy were randomly divided into suture group (n=44) and Kirschner wire group (n=44). In the suture group, the conventional suture to the abdominal wall and diaphragm foot was "V" type to block the liver. With the use of Kirschner wire, different sites could be selected to block the liver or block the exposure field of fat in the abdominal cavity. The liver function, length of hospitalization, duration of operation, hospitalization expenses, intraoperative condition (presence or absence of liver bleeding) and complications of Kirschner wire (infection, bleed, etc.) were compared between the two groups. 
Results The length of hospitalization of patients in the suture group was (4.80±0.70) d, hospitalization expenses were (52 423.22±3 956.57) yuan, the duration of operation was (100.14±5.51) min, and there were 2 patients with liver bleeding. The length of hospitalization of patients in the Kirschner wire group was (4.77±0.80) d, hospitalization expenses were (50 986.61±4 114.21) yuan, the duration of operation was 88.00 (5.75) min, and there was no patient with liver bleeding. There was no significant difference between the two groups in terms of the length of hospitalization and the hospitalization expenses (P＞0.05), but there was significant difference between the two groups in terms of the duration of operation and liver bleeding (P＜0.05). There was no significant difference in ALT and AST before operation and at 1 d after operation (P＞0.05). 
Conclusion Compared with the suture method, the application of Kirschner wire can significantly expand the exposure range of the operation field, effectively shorten the duration of operation, does not increase the use of trocar, and has no related complications. It has great advantages in safety, beauty, manpower, and economy, and the application effect is favorable. 

Key words: metabolic syndrome, gastrectomy, Kirschner wire