OBJECTIVETo evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) for achieving type 2 diabetes mellitus (T2DM) remission in patients with body mass index (BMI) in the range of 25-35 kg/m(2).

METHODSTwenty-two non-morbidly obese (BMI: 25-35 kg/m(2)) patients with T2DM underwent LRYGB. The changes of BMI, fasting plasma glucose (FPG), and glycosylated hemoglobin (HbA1c) levels were recorded, and the prognostic factors were analyzed.

RESULTSAll these 22 patients successfully underwent LRYGB and were followed up for twelve months. Two patients (9.1%) developed complications: one patient had an early hemorrhage at the gastrojejunostomy site, and the other had frequent loose stools that required revision surgery. At 12 months, 14 patients (63.6%) showed T2DM remission, 6 (27.3%) showed glycemic control, and 2(9.1%) showed improvement. Compared with the latter two groups, patients in the T2DM remission group had significantly higher BMI (P=0.001), younger age (P=0.002), and shorter duration of diabetes (P=0.001) before operation.

CONCLUSIONSLYRGB can efficiently and safely treat T2DM in non-morbidly obese patients. Early intervention in these patients may yield better outcomes.

Adult ; Diabetes Mellitus, Type 2 ; complications ; surgery ; Female ; Gastric Bypass ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity ; complications ; Prognosis ; Treatment Outcome

Purpose: Both primary and revisional bariatric surgery are on the rise due to global obesity pandemic. This study aimed to assess the indications for revision after one-anastomosis gastric bypass (OAGB) and the outcomes after laparoscopic conversion of OAGB to roux-en-y gastric bypass (RYGB). Materials and Methods: Retrospective review on patients that had undergone conversion of OAGB to RYGB between June 2007-June 2019 in a tertiary bariatric center, followed by literature review. Results: Out of 386 revisional bariatric surgery, a total of 14 patients underwent laparoscopic conversion of OAGB to RYGB. The mean age was 44.7 with 71% female. The mean pre-revision BMI was 29.2 kg/m2 . The primary indications for revision were bile reflux (n=7), marginal ulcer (n=3), inadequate weight loss or weight regain (IWL/WR) (n=3) and protein-calorie malnutrition (n=1). Conversion of OAGB to RYGB was completed laparoscopically in all cases.The mean length of stay was 4.1 days. There was no intraoperative or early post-operative complication. The mean total weight loss (rTWL%) after revision at year one, year three and year five post-revision were 11.5%, 18.1% and 29.1%, respectively. All patients achieved resolution of bile reflux and marginal ulcer. There was no mortality in this cohort. Conclusion Bile reflux, marginal ulcer, IWL/WR and malnutrition were the main indications for revision after OAGB in this study. In concordance with the available evidence, laparoscopic conversion of OAGB to RYGB was safe and effective in dealing with late complications of OAGB.

Purpose: Both primary and revisional bariatric surgery are on the rise due to global obesity pandemic. This study aimed to assess the indications for revision after one-anastomosis gastric bypass (OAGB) and the outcomes after laparoscopic conversion of OAGB to roux-en-y gastric bypass (RYGB). Materials and Methods: Retrospective review on patients that had undergone conversion of OAGB to RYGB between June 2007-June 2019 in a tertiary bariatric center, followed by literature review. Results: Out of 386 revisional bariatric surgery, a total of 14 patients underwent laparoscopic conversion of OAGB to RYGB. The mean age was 44.7 with 71% female. The mean pre-revision BMI was 29.2 kg/m2 . The primary indications for revision were bile reflux (n=7), marginal ulcer (n=3), inadequate weight loss or weight regain (IWL/WR) (n=3) and protein-calorie malnutrition (n=1). Conversion of OAGB to RYGB was completed laparoscopically in all cases.The mean length of stay was 4.1 days. There was no intraoperative or early post-operative complication. The mean total weight loss (rTWL%) after revision at year one, year three and year five post-revision were 11.5%, 18.1% and 29.1%, respectively. All patients achieved resolution of bile reflux and marginal ulcer. There was no mortality in this cohort. Conclusion Bile reflux, marginal ulcer, IWL/WR and malnutrition were the main indications for revision after OAGB in this study. In concordance with the available evidence, laparoscopic conversion of OAGB to RYGB was safe and effective in dealing with late complications of OAGB.