title: Loop Duodenojejunal Bypass with Sleeve Gastrectomy: Comparative Study with Roux-en-Y Gastric Bypass in Type 2 Diabetic Patients with a BMI <35 kg/m(2), First Year Results.
abstract: Roux-en-Y gastric bypass (RYGB) has shown good diabetes remission in obese patients with type 2 diabetes mellitus (T2DM), but long-term complications were observed. We developed loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) to achieve diabetes remission and avoid the drawbacks of RYGB. We compare 1-year results between LDJB-SG and RYGB with body mass index (BMI) <35 kg/m(2) of T2DM patients.
  
  
  
  We conducted a case-matched study of BMI < 35 kg/m(2) T2DM patients who underwent RYGB and LDJB-SG matching on age, BMI, and duration of diabetes. The 1-year surgical results were compared.
  
  
  
  Sixty patients were included from March 2010 to August 2012. Thirty patients underwent RYGB and 30 underwent LDJB-SG. The operative time (mean ± SD) and length of stay (median [IQR]) were significantly longer in the LDJB-SG group than in the RYGB group (127.0 ± 40.2 vs. 105.0 ± 64.7 min and 3[3, 4] vs. 3[2, 3] days, respectively). There were no statistical differences between the groups in the mean BMI, fasting plasma glucose, and %HbA1c either at baseline or at 1 year. However, these parameters dropped significantly from the preoperative values (p < 0.01). The level of HOMA-%B at 1 year was significantly higher in the LDJB-SG group than in the RYGB group (p = 0.004). The resolution of comorbidities was similar. Late complications seemed higher in the RYGB group (12 vs. 5, p = 0.08). There were no deaths, but two patients in each group required reoperation.
  
  
  
  LDJB-SG was comparable to RYGB in terms of weight loss, glycemic control, and comorbidity resolution in BMI <35 kg/m(2) T2DM patients in the short-term.
authors.affiliation: Body Science and Metabolic Disorders International (BMI) Medical Center, China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Chih Kun
authors.initials: CK
authors.lastname: Huang
authors.affiliation: Bariatric and Metabolic International Surgery Center, E-Da Hospital, Kaohsiung City, Taiwan.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.affiliation: Bariatric and Metabolic International Surgery Center, E-Da Hospital, Kaohsiung City, Taiwan.
authors.forename: Po-Chih
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Bariatric and Metabolic International Surgery Center, E-Da Hospital, Kaohsiung City, Taiwan.
authors.forename: Kirubakaran
authors.initials: K
authors.lastname: Malapan
authors.affiliation: Bariatric and Metabolic International Surgery Center, E-Da Hospital, Kaohsiung City, Taiwan.
authors.forename: Ching-Chung
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Department of Surgery, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand. j-i-n-n@hotmail.com.
authors.forename: Kamthorn
authors.initials: K
authors.lastname: Yolsuriyanwong
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015431:Weight Loss
chemical_list: D001786:Blood Glucose
keywords: Loop duodenojejunal bypass; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes mellitus