title: Biliopancreatic limb plays an important role in metabolic improvement after duodenal-jejunal bypass in a rat model of diabetes.
abstract: OBJECTIVE
  Roux-en-Y gastric bypass improves glucose metabolism in clinical practice, and duodenal-jejunal bypass (DJB), an experimental bypass procedure, also improves metabolism in animals. However, the mechanism remains controversial; especially, the role of the biliopancreatic limb (BP-limb) remains unclear. Our aim was to examine the importance of the function of the BP-limb after DJB using a novel operative model.
  
  
  METHODS
  Otsuka Long-Evans Tokushima Fatty rats with diabetes were divided into the following groups: DJB with a short alimentary limb (A-limb) and long BP-limb (B-DJB group), DJB with jejunectomy (J-DJB group) in which the entire length of the jejunum used for the BP-limb of the B-DJB group was excised; and a sham operation group. Glucose tolerance, plasma bile acid levels, and the gut microbiota were assessed postoperatively.
  
  
  RESULTS
  Glucose tolerance was improved and weight gain was suppressed after surgery in the B-DJB group. In contrast, these effects were cancelled in the J-DJB group. The plasma levels of bile acids in the B-DJB group were greater than those in other groups. The analysis of gut microbiota showed distinct differences between the B-DJB and other groups; especially, the relative abundance of genus Bifidobacterium was much higher in the B-DJB group.
  
  
  CONCLUSIONS
  The BP-limb played an important role in the control of weight gain, glucose tolerance, and increased plasma bile acid levels after DJB in this rat model of type 2 diabetes mellitus. Plasma bile acids and gut microbiota may be involved in these processes.
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Miyachi
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Surgery, Tohoku Pharmaceutical University Hospital, Sendai, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Shibata
authors.affiliation: Institute for Innovation, Ajinomoto Co., Inc., Kanagawa, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kitahara
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: naitot@surg1.med.tohoku.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Naitoh
authors.affiliation: Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D050110:Bariatric Surgery / Q000379:methods*; D001647:Bile Acids and Salts / Q000097:blood; D001659:Biliary Tract / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D000069196:Gastrointestinal Microbiome; D005951:Glucose Tolerance Test; D007583:Jejunum / Q000601:surgery*; D008297:Male; D010179:Pancreas / Q000378:metabolism*; D011897:Random Allocation; D051381:Rats; D020334:Rats, Inbred OLETF; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001647:Bile Acids and Salts; D015415:Biomarkers