Surgical Results of Laparoscopic Loop Duodenojejunal Bypass with Sleeve Gastrectomy (LDJB-SG) in Obese Asians (BMI ≥ 27.5 kg/m2 ) with Type 2 Diabetes Mellitus (T2DM): A New Promising Bariatric and Metabolic Surgery

Abstract

Objective: To demonstrate surgical outcomes, safety and complications in obese Asians (BMI > 27.5 kg/m2 ) who underwent LDJB-SG in our center. Methods: We retrospectively reviewed ninety-one patients who underwent LDJB-SG from October 2011 to March 2014. One-year surgical outcomes regarding the efficacy of weight loss, safety as well as complications of this procedure were demonstrated. Remission of T2DM and co-morbidities resolution after one year were also analyzed. Results: The median duration of T2DM was 60 months and the median operative time was 140 min. Interestingly, the mean/median preoperative BMI, HbA1C and FPG levels dropped significantly from 30.7 kg/m2 , 8.9%, and 139.0 mg% to 23.7 kg/m2 , 6.2%, and 95.0 mg% respectively at 1 year after operation (p<0.001). Furthermore, 61.5% of patients who had completed 1 year follow-up showed complete diabetic remission and 92.3% experienced glycemic control (HbA1c<7% without any medication). The postoperative complications were intra-abdominal bleeding (4.4%), leakage (1.1%), stricture (3.3%) and port site hernia (2.2%). Conclusion: LDJB-SG is a safe and feasible bariatric and metabolic surgery, which has demonstrated excellent outcomes in terms of weight reduction, co-morbidities resolution as well as glycemic control in short-term follow-up.

Keywords

• Loop duodenojejunal bypass with sleeve gastrectomy
• type 2 diabetes mellitus
• Obese Asians
• (Siriraj Med J 2018;70: 103-113)