Sleeve Gastrectomy with Jejunal Bypass for the Treatment of Type 2 Diabetes Mellitus in Patients with Body Mass Index <35 kg/m2. A cohort study

Obesity Surgery, 04/30/2012

One patient experienced postoperative gastrointestinal bleeding. There were no deaths. Sleeve gastrectomy with jejunal bypass (SGJB)is an effective treatment for T2DM in patients with BMI <35 kg/m2.

Methods

  • This is a prospective cohort study.
  • Patients with T2DM and BMI <35 kg/m2 who underwent SGJB between January 2009 and June 2011 at DIPRECA Hospital, in Santiago, and Hospital Base, Osorno, Chile were included.
  • SGJB consists of creating a gastric tube, which preserves the pylorus, and performing a jejunoileal anastomosis 300 cm distal to the angle of Treitz.
  • Excess weight loss (EWL) and complete or partial remission of T2DM were reported.

Results

  • Forty–nine patients met the inclusion criteria
  • The mean age was 49 years (36–62), and 53 % of patients were female.
  • Mean preoperative BMI was 31.6 kg/m2 (25–34.9 kg/m2).
  • Operation time was 123±14 min, with 94.7 % of operations performed laparoscopically. Mean postoperative hospital stay was 2 days.
  • Mean postoperative follow–up was 12 months. Median EWL at 1, 3, 6, 12, and 18 months postoperatively was 31.9 %, 56.9 %, 76.1 %, 81.5 %, and 76.1 %, respectively.
  • Complete T2DM remission was achieved in 81.6 % of patients (40/49) and partial remission in 18.4 % (9/49).
  • Forty of 41 patients (97.6 %) on oral hypoglycemic agents achieved complete T2DM remission, and 100 % of insulin–dependent patients stopped using insulin but were still being treated for T2DM.
  • One patient experienced postoperative gastrointestinal bleeding.

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