Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for the Treatment of Morbid Obesity and Metabolic Diseases: a Promising Operation

Obesity Surgery, 05/08/2012

Sleeve gastrectomy plus side–to–side jejunoileal anastomosis appears to be a simple, considerably safe, and effective procedure for treating obesity and its metabolic comorbidities.

Methods

  • Thirty–two patients underwent the novel procedure, sleeve gastrectomy plus side–to–side jejunoileal anastomosis (SG plus), and were followed for 6 to 24 months.
  • A matched cohort of 32 patients underwent sleeve gastrectomy over the same period and was used as the control group.
  • Weight loss, comorbidity outcomes, and the duodenum to cecum transit time after a gastrografin swallow, performed at postoperative day 4, were compared.

Results

  • There were no deaths and no major perioperative complications.
  • Three patients developed long–term complications requiring surgical intervention (intestinal obstruction, nausea–vomiting, and hypoalbuminemia).
  • In the SG plus group, a 77.8 % excess weight loss was achieved at 12 months postoperatively, which was significantly better (p<0.01) than the 67 % observed in the control group.
  • The comorbidity outcomes, particularly diabetes resolution, were also significantly superior in the SG plus patients.
  • The duodenum to cecum transit time of 11 min in the SG plus group was significantly shorter (p<0.01) than the 31 min observed in the control group.

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