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Biliopancreatic diversion with duodenojejunal exclusion associated with truncal vagotomy: a new proposal for type 2 diabetes mellitus treatment / Derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular: uma nova proposta para o tratamento do diabetes melito tipo 2
Alleotti, Edson; Palma, Rogério Tadeu; Pinto Junior, Paulo Engler; Bento, José Antonio; Yonamine, Raquel; Campos, André Luiz Lopes Cardoso; Waisberg, Jaques.
  • Alleotti, Edson; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Palma, Rogério Tadeu; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Pinto Junior, Paulo Engler; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Bento, José Antonio; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Yonamine, Raquel; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Campos, André Luiz Lopes Cardoso; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
  • Waisberg, Jaques; Faculty of Medicine of ABC. Department of Surgery. Santo Andre. BR
Acta cir. bras ; 27(8): 577-584, Aug. 2012. ilus, tab
Article in English | LILACS | ID: lil-643628
ABSTRACT

PURPOSE:

To evaluate the effectiveness of the biliopancreatic diversion surgery with duodenojejunal exclusion in combination with truncal vagotomy in type 2 diabetes mellitus (T2DM) patients with overweight or class I or II obesity.

METHODS:

The study included ten patients with T2DM and class I or II obesity or overweight who were subjected to biliopancreatic diversion with duodenojejunal exclusion in combination with truncal vagotomy. The blood glucose levels during the pre- and postoperative periods were compared using the Friedman test. The significance level adopted was 5%.

RESULTS:

There were significant differences between preoperative and postoperative blood glucose levels at three months (p=0.01), six months (p=0.001) and 12 months (p=0.001). There was also a significant difference between one month postoperative blood glucose and six months postoperative blood glucose (p=0.01). Glycosylated hemoglobin levels decreased in 80% of patients, there was marked improvement in their lipid profiles, and the average BMI reduction was 7.0±1.5 kg/m² at 12 months after the surgery.

CONCLUSION:

In patients with type 2 diabetes mellitus associated with class I/II obesity or overweight, performing biliopancreatic diversion with duodenojejunal exclusion in combination with truncal vagotomy resulted in glycemic control, reduction of excess weight, and improvement of lipid profile 12 months after the surgery.
RESUMO

OBJETIVO:

Avaliar a eficácia da operação de derivação biliopancreática com exclusão duodeno-jejunal associada com vagotomia troncular em doentes com diabetes tipo 2 com sobrepeso ou obesidade classe I ou II.

MÉTODOS:

Foram estudados dez doentes com diabetes melito tipo 2 e sobrepeso ou obesidade grau I ou II submetidos à derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular. Os valores de glicemia no pré e no pós-operatório foram comparados pelo teste de Friedman. O nível de significância adotado foi de 5%.

RESULTADOS:

Houve diferença significante (p=0,01) nas glicemias pré e pós-operatórias de três meses, de seis meses (p=0,001) e de 12 meses (p=0,001). Houve diferença significante entre a glicemia pós-operatória de um mês e glicemia pós-operatória de seis meses (p=0,01). O nível de hemoglobina glicosilada reduziu-se em 80% dos doentes, houve melhora acentuada do perfil lipídico e a média da redução do IMC foi de 7,0±1,5 kg/m² após 12 meses da operação.

CONCLUSÃO:

No paciente com diabetes melito tipo 2 associado com sobrepeso ou obesidade grau I/II, a realização da derivação biliopancreática com exclusão duodeno-jejunal associada à vagotomia troncular proporcionou controle glicêmico, redução do excesso de peso e melhora do perfil lipídico após 12 meses da operação.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Vagotomy, Truncal / Biliopancreatic Diversion / Duodenum / Overweight / Jejunum Type of study: Evaluation studies / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Acta cir. bras Journal subject: General Surgery / Procedimentos Cir£rgicos Operat¢rios Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculty of Medicine of ABC/BR

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Full text: Available Index: LILACS (Americas) Main subject: Vagotomy, Truncal / Biliopancreatic Diversion / Duodenum / Overweight / Jejunum Type of study: Evaluation studies / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Acta cir. bras Journal subject: General Surgery / Procedimentos Cir£rgicos Operat¢rios Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculty of Medicine of ABC/BR