|
KMID : 1035920210240010010
|
|
Journal of Minimally Invasive Surgery
2021 Volume.24 No. 1 p.10 ~ p.17
|
|
|
Safety and feasibility of laparoscopic sleeve gastrectomy with loop duodenojejunal bypass for obesity
|
|
Vennapusa Amar
Panchangam Ramakanth Bhargav
Kesara Charita
Mallick Nazneen
|
|
|
Abstract
|
|
|
Purpose: Laparoscopic sleeve gastrectomy (SG) with loop duodenojejunal bypass (LDJB) is a combination of SG and one anastomosis gastric bypass surgeries. This study was intended to evaluate the safety and feasibility of SG-LDJB surgery.
Methods: This was a retrospective study analyzing SG-LDJB surgery using 250-cm length biliopancreatic limbs that was performed between May 2013 and December 2017 in 113 Indians with obesity. All demographic, clinical, operative, and follow-up data were analyzed for weight loss and diabetes remission efficacy. Weight-loss success was defined as percentage of total weight loss (%TWL) ≥ 25%. Diabetes remission was defined as hemoglobin A1c < 6% without the need for antidiabetic medications. Safety and feasibility were analyzed in terms of intraoperative and postoperative complications and serum albumin, iron, and calcium levels.
Results: The %TWL was 35.0% and 31.0% at the 1-year and 3-year follow-ups, respectively. The weight-loss success rate was 91.3% and 78.1% at the 1-year and 3-year follow-ups, respectively. Sixty-six out of 113 patients had type 2 diabetes. Diabetes remission was 80.0% and 75.4% at the 1-year and 3-year follow-ups, respectively. Major perioperative complications occurred in 0.9% of the patients. The 30-day mortality rate was zero. None of the patients had serum albumin levels of <3 g/dL at the 1-year and 3-year follow-ups or symptoms of hypoproteinemia.
Conclusion: SG-LDJB surgery using a 250-cm biliopancreatic limb is a safe and effective procedure to treat obesity. It is technically complex but has the advantages of endoscopic access to the stomach and negligible postoperative complications or hypoproteinemia.
|
|
|
KEYWORD
|
|
|
Bariatric surgery, Diabetes mellitus, Metabolic surgery, Obesity, Weight loss
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|