title: Metabolic effects of an entero-omentectomy in mildly obese type 2 diabetes mellitus patients after three years.
abstract: BACKGROUND
  Various digestive tract procedures effectively improve metabolic syndrome, especially the control of type 2 diabetes mellitus. Very good metabolic results have been shown with vertical gastrectomy and entero-omentectomy; however, the metabolic effects of an isolated entero-omentectomy have not been previously studied.
  
  
  METHODS
  Nine patients with type 2 diabetes mellitus and a body mass index ranging from 29 to 34.8 kg/m² underwent an entero-omentectomy procedure that consisted of an enterectomy of the middle jejunum and exeresis of the major part of the omentum performed through a mini-laparotomy. Glucagon-like peptide-1 and peptide YY were measured preoperatively and three months following the operation. Fasting and postprandial variations in glycemia, insulinemia, triglyceridemia, hemoglobin A1c, and body mass index were determined in the preoperative period and 3, 18 and, 36 months after the operation.
  
  
  RESULTS
  All patients significantly improved the control of their type 2 diabetes mellitus. Postprandial secretion of peptide YY and Glucagon-like peptide-1 were enhanced, whereas hemoglobin A1c, fasting and postprandial glucose, insulin, and triglyceride levels were significantly reduced. Mean body mass index was reduced from 31.1 to 27.3 kg/m². No major surgical or nutritional complications occurred.
  
  
  CONCLUSIONS
  Entero-omentectomy is easy and safe to perform. A simple reduction in jejunal extension and visceral fat causes important improvements in the metabolic profile.
authors.affiliation: Departamento de Cirurgia, Hospital Vicentino da Sociedade Beneficente São Camilo, Ponta Grossa, PR, Brazil.
authors.forename: Fábio Quirilo
authors.initials: FQ
authors.lastname: Milleo
authors.forename: Antonio Carlos Ligocki
authors.initials: AC
authors.lastname: Campos
authors.forename: Sérgio
authors.initials: S
authors.lastname: Santoro
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Lacombe
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Santo
authors.forename: Marcelo Ricardo
authors.initials: MR
authors.lastname: Vicari
authors.forename: Viviane
authors.initials: V
authors.lastname: Nogaroto
authors.forename: Roberto Ferreira
authors.initials: RF
authors.lastname: Artoni
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D024821:Metabolic Syndrome / Q000601:surgery; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D009852:Omentum / Q000601:surgery*; D019894:Peptide YY / Q000378:metabolism; D011184:Postoperative Period; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019894:Peptide YY; D052216:Glucagon-Like Peptide 1