Three-year result of efficacy for type 2 diabetes mellitus control between laparoscopic duodenojejunal bypass compared with laparoscopic Roux-en-Y gastric bypass.
10.4174/astr.2017.93.5.260
- Author:
Dong Jin KIM
1
;
Kwang Yeol PAIK
;
Mee Kyoung KIM
;
Eungkook KIM
;
Wook KIM
Author Information
1. Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. kimwook@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Bariatric surgery;
Diabetes mellitus;
Laparoscopy
- MeSH:
Bariatric Surgery;
Body Mass Index;
Body Weight;
C-Peptide;
Diabetes Mellitus;
Diabetes Mellitus, Type 2*;
Follow-Up Studies;
Gastric Bypass*;
Hemoglobin A, Glycosylated;
Humans;
Laparoscopy;
Length of Stay;
Male;
Methods;
Obesity, Morbid
- From:Annals of Surgical Treatment and Research
2017;93(5):260-265
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The mechanism by which bariatric surgery facilitates diabetic control is still unknown. Duodenojejunal bypass supports the foregut theory; however, its efficacy when used alone is not yet established. METHODS: During the period from January 2008 to December 2009, patients who underwent laparoscopic duodenojejunal bypass (LDJB) or laparoscopic Roux-en-Y gastric bypass (LRYGB) for type 2 diabetes mellitus (T2DM) with or without morbid obesity were included. Patients who had a follow-up for less than 3 years were excluded. Patient baseline characteristics, change of body weight, body mass index (BMI), glycosylated hemoglobin (HbA1c), and diabetic treatments were analyzed. RESULTS: In total, 8 LDJB and 20 LRYGB patients were analyzed. The LDJB group had more number of male patients than the LRYGB group (LDJB 75% vs. LRYGB 30%, P = 0.030). Baseline BMI in the LRYGB group was higher than in the LDJB group (LDJB 27.0 ± 2.5 vs. LRYGB 32.6 ± 3.4, P < 0.001). Age, DM duration, baseline HbA1c, and C-peptide levels were similar. Longer operation time was needed to perform LDJB (LDJB 367.5 ± 120.2 vs. LRYGB 232.9 ± 41.1, P < 0.001), but no differences were observed in the hospital stay and complication rate between the 2 groups. At the third year of follow-up, the T2DM remission rate was observed in 40% of patients in the LRYGB group and 12.5% of patients in the LDJB group. CONCLUSION: LDJB is not an effective method for controlling T2DM compared with LRYGB. Foregut theory may not be the main mechanism of diabetic control during bariatric surgery.
