Efficacy of modified laparoscopic gastric bypass in the treatment of type 2 diabetes mellitus / 中华消化外科杂志

ABSTRACT

Objective To investigate the efficacies of conventional and modified laparoscopic gastric bypass in the treatment of type 2 diabetes mellitus.Methods The clinical data of 30 patients with type 2 diabetes mellitus who were admitted to the Xijing Hospital of the Fourth Military Medical University from January 2012 to October 2012 were prospectively analyzed.All the 30 patients were randomly divided into the conventional group (15 patients) and the modified group (15 patients) according to the random number table.Patients in the 2 groups received conventional and modified laparoscopic gastric bypass,respectively.The operation time,blood loss,anal exhaust time,duration of postoperative hospital stay,incidence of severe complications,postoperative 3-month body mass index (BMI),fasting plasma glucose (FPG),fasting serum insulin (Fins),fasting serum C-peptide (FC-P) and glycosylated hemoglobin (HbAlc) of the 2 groups were compared.The measurement data were analyzed using the t test,and the count data were analyzed using the Fisher exact probability.Results The operation time of the conventional group and the modified group were (141 ± 22)minutes and (113 ± 26)minutes,with significant difference between the 2 groups (t =3.184,P ＜ 0.05).The volume of intraoperative blood loss,anal exhaust time,duration of postoperative hospital stay,postoperative 3-month BMI,FPG,Fins,FC-P and HbAlc were (65 ±29)ml,(2.5 ±1.2)days,(7.5 ±2.1)days,(27 ±4)kg/m2,(6.7 ±1.5)mmol/L,(18 ± 8) mU/L,(2.0 ± 0.6) μg/L and 5.8％ ± 1.5 ％ in the conventional group,and (57 ± 25) ml,(2.1 ± 1.0) days,(7.1 ± 1.9) days,(28 ± 4) kg/m2,(6.4 ± 2.0) mmol/L,(17 ± 6) mU/L,(1.9 ± 0.6) μg/L and 6.1％ ± 1.4％ in the modified group,with no significant difference between the 2 groups (t =0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P ＞ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAle of the conventional group were (31 ± 4) kg/m2,(11.3 ± 2.3) mmol/L,(13 ± 4) mU/L,(1.4 ± 0.5) μg/L and 8.6％ ± 1.0％,which were significantly different from those at 3 months after operation (t =2.304,6.615,3.109,2.920,5.997,P ＜ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAlc of the modified group were (31 ±4)kg/m2,(11.9±2.4)mmol/L,(12±5)mU/L,(1.4 ±0.6) μg/L and 8.9％±0.9％,which were significant different from those at 3 months after operation (t =2.165,6.711,2.616,2.478,6.571,P ＜0.05).Conclusion The safety and short-term efficacy of modified laparoscopic gastric bypass are comparable to those of the conventional laparoscopic gastric bypass,but the operation time of the modified method is significantly shorter.