PMID- 26749411
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20221207
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 26
IP  - 9
DP  - 2016 Sep
TI  - Laparoscopic Sleeve Gastrectomy with Duodenojejunal Bypass for Type 2 Diabetes 
      Mellitus.
PG  - 2035-2044
LID - 10.1007/s11695-016-2057-8 [doi]
AB  - BACKGROUND: Laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB), 
      which has been positioned as a novel bariatric procedure, is the combination of 
      vertical sleeve gastrectomy and proximal intestinal bypass and is theoretically 
      expected to have strong anti-diabetic effect. Also, preserving the pylorus, a 
      physiological valve, leads to less occurrence of dumping syndrome and anastomotic 
      stenosis which are often problematic after laparoscopic Roux-en-Y gastric bypass 
      (LRYGB), a gold standard. The purpose of this study was to investigate the 
      clinical effects of LSG-DJB on obese patients with type 2 diabetes mellitus 
      (T2DM). METHODS: Consecutive 75 obese patients (female 44/male 31) associated 
      with T2DM who underwent LSG-DJB and were followed up for at least 1 year were 
      analyzed. The mean age was 45.5 +/- 8.6 years, and the mean preoperative body 
      weight (BW) and body mass index (BMI) were 108.4 +/- 21.4 kg and 
      39.6 +/- 7.3 kg/m(2), respectively. The mean hemoglobin A1c (HbA1c) at the first 
      visit was 9.0 +/- 1.9 %, and the duration of T2DM from diagnosis was 
      7.2 +/- 6.2 years. Thirty-six out of the 75 patients (48 %) were treated with 
      insulin preoperatively. All patients were evaluated and managed under a strict 
      multidisciplinary team approach. The follow-up rate at 1 year was 89 %. RESULTS: 
      At 1 year, the mean BW and BMI significantly dropped to 74.6 +/- 16.9 kg and 
      27.5 +/- 5.7 kg/m(2), respectively. The mean percent of excess weight loss (%EWL) 
      and percent of total body weight loss (%TWL) were 99.4 +/- 42.4 and 31.6 +/- 8.8 %, 
      respectively. Consequently, 68.7 % of the patients achieved HbA1c less than 6 %, 
      and 82.1 % of them achieved HbA1c less than 6.5 % without diabetes medications. 
      Glycemic control of HbA1c less than 7 % was achieved in 91.0 % of the patients. 
      The percentage of patients who satisfied the American Diabetes Association 
      (ADA)-defined composite endpoints for cardiovascular disease (CVD) risk factor 
      control increased from 0 % (at baseline) to 31 % (at 1 year). A meal tolerance 
      test revealed significant reduction of glucose area under the curve (AUC) and 
      increase of insulin AUC postoperatively. CONCLUSIONS: LSG-DJB for obese patients 
      with T2DM has strong anti-diabetic effect in the short-term; however, a larger 
      number of patients with a longer follow-up period are needed for definitive 
      conclusions.
FAU - Seki, Yosuke
AU  - Seki Y
AD  - Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, 
      Chiyoda-ku, Tokyo, 102-0084, Japan. seki@mcube.jp.
FAU - Kasama, Kazunori
AU  - Kasama K
AD  - Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, 
      Chiyoda-ku, Tokyo, 102-0084, Japan.
FAU - Umezawa, Akiko
AU  - Umezawa A
AD  - Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, 
      Chiyoda-ku, Tokyo, 102-0084, Japan.
FAU - Kurokawa, Yoshimochi
AU  - Kurokawa Y
AD  - Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, 
      Chiyoda-ku, Tokyo, 102-0084, Japan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Diabetes Mellitus, Type 2/*surgery
MH  - Duodenum/surgery
MH  - Female
MH  - Gastrectomy/methods
MH  - Gastric Bypass/methods
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Jejunum/surgery
MH  - Laparoscopy/methods
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*surgery
MH  - Treatment Outcome
MH  - *Weight Loss
MH  - Young Adult
OTO - NOTNLM
OT  - Asian
OT  - DJB
OT  - Diabetes
OT  - Duodenojejunal bypass
OT  - Japanese
OT  - Laparoscopic
OT  - Sleeve gastrectomy
OT  - T2DM
EDAT- 2016/01/11 06:00
MHDA- 2018/01/03 06:00
CRDT- 2016/01/11 06:00
PHST- 2016/01/11 06:00 [entrez]
PHST- 2016/01/11 06:00 [pubmed]
PHST- 2018/01/03 06:00 [medline]
AID - 10.1007/s11695-016-2057-8 [pii]
AID - 10.1007/s11695-016-2057-8 [doi]
PST - ppublish
SO  - Obes Surg. 2016 Sep;26(9):2035-2044. doi: 10.1007/s11695-016-2057-8.