Abstract
Background
Laparoscopic sleeve gastrectomy (SG) has become accepted as a stand-alone procedure
as a less complex operation than laparoscopic duodenojejunal bypass with sleeve gastrectomy
(DJB-SG).
Objectives
The aim of this study was to compare one-year results between DJB-SG and SG.
Setting
University hospital.
Methods
A total of 89 patients who received a DJB-SG surgery were matched with a group of
SG that were equal in age, sex, and body mass index (BMI). Complication rates, weight
loss, and remission of co-morbidities were evaluated after 12 months.
Results
The mean preoperative patient BMI in the DJB-SG and SG groups was similar. There were
more patients with type 2 diabetes mellitus (T2DM) in the DJB-SG group than in the
SG group. The mean operative time and length of hospital stay (LOS) were significantly
longer in the DJB-SG group than in the SG group. At 12 months after surgery, the BMI
was lower and excess weight loss higher in DJB-SG than SG. Remission of T2DM was greater
in the DJB-SG group. Low-density lipoprotein, total cholesterol, and metabolic syndrome
(MS) improved after operation in both groups.
Conclusions
In this study DJB-SG was superior to SG in T2DM remission, triglyceride improvement,
excess weight loss, and lower BMI at 1 year after surgery. Adding duodenal switch
to sleeve gastrectomy increases the effect of diabetic control and MS resolution.
Keywords
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References
- Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.JAMA. 2012; 307: 491-497
- Global and societal implications of the diabetes epidemic.Nature. 2001; 414: 782-787
- Metabolic/bariatric surgery worldwide 2011.Obes Surg. 2013; 23: 427-436
- Bariatric surgery: a systematic review and meta-analysis.JAMA. 2004; 292: 1724-1737
- Surgical treatment of obesity.Nat Clin Pract Endocrinol Metab. 2007; 3: 574-583
- Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study.Ann Surg. 2008; 247: 401-407
- Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results.Obes Surg. 2013; 23: 292-299
- Current status of bariatric surgery in Japan and effectiveness in obesity and diabetes.J Gastroenterol. 2014; 49: 57-63
- Results of a national survey on laparoscopic bariatric surgery in Japan, 2000-2009.Asian J Endosc Surg. 2011; 4: 138-142
- Laparoscopic sleeve gastrectomy for diabetes treatment in nonmorbidly obese patients: efficacy and change of insulin secretion.Surgery. 2010; 147: 664-669
- Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes.N Engl J Med. 2014; 370: 2002-2013
- Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial.Arch Surg. 2011; 146: 143-148
- Minireview: Hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery.Endocrinology. 2009; 150: 2518-2525
- Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results.Obes Surg. 2009; 19: 1341-1345
- Laparoscopic duodenojejunal bypass with sleeve gastrectomy: preliminary results of a prospective series from India.Surg Endosc. 2012; 26: 688-692
- Laparoscopic sleeve gastrectomy with duodenojejunal bypass for severe obesity and/or type 2 diabetes may not require duodenojejunal bypass initially.Obes Surg. 2010; 20 (author reply 5–6): 1323-1324
- Bariatric surgery: Asia-Pacific perspective.Obes Surg. 2005; 15: 751-757
- International Diabetes Federation Taskforce on E, Prevention. Bariatric surgery: an IDF statement for obese Type 2 diabetes.Diabet Med. 2011; 28: 628-642
- Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight.Obes Surg. 2008; 18: 294-299
- Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG): short-term result and comparison with gastric bypass.Obes Surg. 2014; 24: 109-113
- Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage.Surg Endosc. 2010; 24: 2253-2259
- The Clavien-Dindo classification of surgical complications: five-year experience.Ann Surg. 2009; 250: 187-196
- A new paradigm for type 2 diabetes mellitus: could it be a disease of the foregut?.Ann Surg. 1998; 227 (discussion 43–4): 637-643
- Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes: a new perspective for an old disease.Ann Surg. 2004; 239: 1-11
- The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes.Ann Surg. 2006; 244: 741-749
- Clinical improvement after duodenojejunal bypass for nonobese type 2 diabetes despite minimal improvement in glycemic homeostasis.World J Surg. 2009; 33: 972-979
- Prospective randomized controlled trial comparing 2 versions of laparoscopic ileal interposition associated with sleeve gastrectomy for patients with type 2 diabetes with BMI 21-34 kg/m(2).Surg Obes Relat Dis. 2010; 6: 296-304
- The preliminary clinical experience with laparoscopic duodenojejunal bypass for treatment of type 2 diabetes mellitus in non-morbidly obese patients: the 1-year result in a single institute.Surg Endosc. 2012; 26: 3287-3292
- Lower fetuin-A, retinol binding protein 4 and several metabolites after gastric bypass compared to sleeve gastrectomy in patients with type 2 diabetes.PLoS One. 2014; 9: e96489
- Gastric cancer after Roux-en-Y gastric bypass.Obes Surg. 2005; 15: 423-427
- Gastric cancer after mini-gastric bypass surgery: a case report and literature review.Asian J Endosc Surg. 2013; 6: 303-306
Article info
Publication history
Published online: December 23, 2014
Accepted:
December 15,
2014
Received:
September 21,
2014
Identification
Copyright
© 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
