title: A Simple Food-Diverting Operation for Type 2 Diabetes Treatment. Preliminary Results in Humans with BMI 28-32 kg/m2.
abstract: The feasibility of a simple side-to-side jejunoileal anastomosis (SJA) in non-morbidly obese individuals to control type 2 diabetes mellitus (T2DM) was studied in six diabetic patients with BMI 28-32. This novel procedure was performed in two Academic Centers and preliminary data is presented.
  
  
  
  SJA bypassing a significant part of the small bowel and diverting food and biliopancretic secretions to the distal ileum was performed laparoscopically in six diabetic patients with BMI 28-32 kg/m2. SJA was performed at a distance of 100 cm from the Treitz ligament and 150 cm from the ileocecal valve, thus a total bowel alimentary and biliopancreatic loop length of 2.5 m was created.
  
  
  
  Three of the patients (two female, one male) experienced complete remission of diabetes from the immediate postoperative period and up to 3 years after the procedure. Two other patients remained medication-free after the operation experiencing partial diabetes remission, and the third patient significantly reduced his daily insulin requirements immediately after surgery. There were no early or late postoperative complications.
  
  
  
  A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to control T2DM in all patients offering total or partial remission of the disease soon after the procedure. Those preliminary data and the simplicity of the operation are encouraging and promising. However, further studies are in progress in both Institutions to reveal the possible mechanism of diabetes control and investigate the effect of this operation on larger number of patients, with longer follow-up period.
authors: Bariatric Unit, Department of Surgical Oncology, Heraklion University Hospital, Medical School, University of Crete, 164 Erythreas str, Heraklion, 71409, Greece. melissas@med.uoc.gr.
authors: John
authors: J
authors: Melissas
authors: Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Halit
authors: H
authors: ErenTaskin
authors: Bariatric Unit, Department of Surgical Oncology, Heraklion University Hospital, Medical School, University of Crete, 164 Erythreas str, Heraklion, 71409, Greece.
authors: Drakos
authors: D
authors: Peirasmakis
authors: Bariatric Unit, Department of Surgical Oncology, Heraklion University Hospital, Medical School, University of Crete, 164 Erythreas str, Heraklion, 71409, Greece.
authors: Efstathios
authors: E
authors: Dimitriadis
authors: University Hospital Witten/Herdecke, Wuppertal, Germany.
authors: Marios
authors: M
authors: Papadakis
authors: Department of Anesthesiology and Reanimation, Bezmi Alem Vakif University, Istanbul, Turkey.
authors: Seniyye Ulgen
authors: SU
authors: Zengin
authors: Department of Endocrinology and Metabolism, Cerrahpasa, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Volkan
authors: V
authors: Yumuk
authors: Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors: Mustafa
authors: M
authors: Taskin
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Diabetes type 2; Jejunoileal anastomosis; Metabolic surgery