J Metab Bariatr Surg.  2020 Dec;9(2):61-67. 10.17476/jmbs.2020.9.2. 1.

Short-Term Outcomes of Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass for Morbid Obesity

• Jo YG
• Yuem JH
• Kim JM
• Choi SI

• KMID: 2509523
• DOI: http://doi.org/10.17476/jmbs.2020.9.2. 1

Abstract

Purpose
This study aimed to evaluate the safety and feasibility of laparoscopic sleeve gastrectomy with duodenojejunal bypass (SDJB) surgery in Korean patients.
Materials and Methods
This was a retrospective study analyzing SDJB surgery with a 200-cm biliopancreatic limb; the surgery was performed between January 2019 and August 2020 in 56 Koreans with morbid obesity. All demographic, clinical, operative, and follow-up data were documented and analyzed for weight loss and diabetes remission efficacy. Safety and feasibility were analyzed in terms of perioperative and postoperative complications. A decrease in the HbA1c value and discontinuation or reduction of anti-diabetics were considered as indicators of improvement in diabetes.
Results
The median operation time was 180.0 min (105-210 min), and the median postoperative hospital stay was 5.0 days (3-35 days). Postoperative complications occurred in two patients who were managed by conversion to Roux-en-Y gastric bypass surgery. Meaningful weight loss was 3.5%, 27.7%, and 54.9% at the 1-month, 3-month, and 6-month follow-ups, respectively. Of the 56 patients, 46 had type 2 diabetes. Among those patients, at the 1-month follow-up, 4/31 patients (12%), at the 3-month follow-up, 22/41 patients (53.6%), and at the 6-month follow-up, 31/42 patients (73.8%) were found to show improvement. Of the patients who received anti-diabetics or insulin therapy, only three (9%) patients continued to receive reduced treatment of diabetes, and the other thirty (91%) discontinued the anti-diabetics.
Conclusion
SDJB surgery with a 200-cm biliopancreatic limb was a safe and effective procedure to treat morbid obesity and diabetes.

Keyword

Bariatric surgery; Metabolic surgery; Obesity; Diabetes; Laparoscopic sleeve gastrectomy with duodenojejunal bypass