title: Technical feasibility and safety profile of laparoscopic diverted sleeve gastrectomy with ileal transposition (DSIT).
abstract: BACKGROUND
  In this study, we specifically aimed to analyze the technical and safety aspects of laparoscopic diverted sleeve gastrectomy with ileal transposition (DSIT) in patients with type 2 diabetes (T2DM).
  
  
  METHODS
  A total of 360 patients with type 2 diabetes who underwent a DSIT procedure within the past 2-year period (2011-2013) were analyzed. Operation time, length of hospital stay, perioperative and postoperative complications, and mortality were recorded and analyzed.
  
  
  RESULTS
  The participants consisted of 229 males (63.6 %) and 131 females (36.4 %). Mean duration of follow-up was 12.4 months (range, 6-31). One early and two late mortalities occurred. Early mortality was due to an anastomotic leak, and late mortalities were related to myocardial infarction and a traffic accident. Leakage and bleeding were the most common surgical complications. The total number of surgical complications was 22 (6.1 %). Of those, 19 occurred within the first month (early) and 3 occurred after the first month (late). Among early complications, seven (1.94 %) required re-operation, two patients (0.55 %) required endoscopic treatment, and the remaining ten were managed conservatively. Late surgical complications (sleeve angulation) were noted in three patients (0.83) and were treated by endoscopic stents. Surgery-related non-surgical complications occurred in 19 cases (5.2 %), and neurological complications were noted in 11 patients (3.05 %). Additional surgical intervention was required in 26 patients (7.22 %). Of those, 15 (4.16 %) required cholecystectomy.
  
  
  CONCLUSIONS
  Our data demonstrate that DSIT is a technically feasible operation and can be safely performed in type 2 diabetic patients with acceptable complication and mortality rates.
authors.affiliation: Metabolic Surgery Clinic, Taksim German Hospital, Istanbul, Turkey, doktoralper@hotmail.com.
authors.forename: Alper
authors.initials: A
authors.lastname: Celik
authors.forename: Surendra
authors.initials: S
authors.lastname: Ugale
authors.forename: Hasan
authors.initials: H
authors.lastname: Ofluoglu
authors.forename: Muharrem
authors.initials: M
authors.lastname: Asci
authors.forename: Bahri Onur
authors.initials: BO
authors.lastname: Celik
authors.forename: Erol
authors.initials: E
authors.lastname: Vural
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult