title: Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats.
abstract: OBJECTIVE
  To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass.
  
  
  METHODS
  We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These included: use of anatomical markers to precisely identify Treitz's ligament; careful dissection along surgical planes; careful attention to the choice of regional transection sites; reconstruction using full-thickness anastomoses; use of a minimally invasive procedure with prohemostatic pretreatment and hemorrhage control; prevention of hypothermic damage; reduction in the length of the procedure; and accelerated surgical recovery using fast-track surgical modalities such as perioperative permissive underfeeding and goal-directed volume therapy.
  
  
  RESULTS
  The series of modifications we adopted reduced operation time from 110.02 ± 12.34 min to 78.39 ± 7.26 min (P < 0.01), and the procedural success rate increased from 43.3% (13/30) to 90% (18/20) (P < 0.01), with a long-term survival of 83.3% (15/18) (P < 0.01).
  
  
  CONCLUSIONS
  Using a number of fast-track and damage control surgical techniques, we have successfully established a stable model of gastric bypass in diabetic rats.
authors.affiliation: Department of General Surgery, Harbin Medical University First Affiliated Hospital, Harbin 150001, Heilongjiang Province, China.
authors.forename: Li-Ou
authors.initials: LO
authors.lastname: Han
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Zhou
authors.forename: Su-Jun
authors.initials: SJ
authors.lastname: Cheng
authors.forename: Chun
authors.initials: C
authors.lastname: Song
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Song
mesh_terms: D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015996:Survival Rate