ABSTRACT
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has become accepted as a stand-alone procedure as a less complex operation than laparoscopic duodenojejunal bypass with sleeve gastrectomy (DJB-SG). OBJECTIVES: The aim of this study was to compare one-year results between DJB-SG and SG. SETTING: University hospital. METHODS: A total of 89 patients who received a DJB-SG surgery were matched with a group of SG that were equal in age, sex, and body mass index (BMI). Complication rates, weight loss, and remission of co-morbidities were evaluated after 12 months. RESULTS: The mean preoperative patient BMI in the DJB-SG and SG groups was similar. There were more patients with type 2 diabetes mellitus (T2DM) in the DJB-SG group than in the SG group. The mean operative time and length of hospital stay (LOS) were significantly longer in the DJB-SG group than in the SG group. At 12 months after surgery, the BMI was lower and excess weight loss higher in DJB-SG than SG. Remission of T2DM was greater in the DJB-SG group. Low-density lipoprotein, total cholesterol, and metabolic syndrome (MS) improved after operation in both groups. CONCLUSIONS: In this study DJB-SG was superior to SG in T2DM remission, triglyceride improvement, excess weight loss, and lower BMI at 1 year after surgery. Adding duodenal switch to sleeve gastrectomy increases the effect of diabetic control and MS resolution.
Subject(s)
Duodenum/surgery , Gastrectomy/methods , Gastric Bypass/methods , Jejunum/surgery , Laparoscopy/methods , Obesity, Morbid/surgery , Weight Loss , Adult , Body Mass Index , Female , Follow-Up Studies , Humans , Male , Retrospective Studies , Treatment OutcomeSubject(s)
Adenocarcinoma/surgery , Esophageal Neoplasms/surgery , Gastric Bypass/methods , Obesity, Morbid/surgery , Adenocarcinoma/etiology , Body Mass Index , Diabetes Mellitus, Type 2/prevention & control , Diagnostic Imaging , Esophageal Neoplasms/etiology , Humans , Lymph Node Excision , Male , Middle Aged , Neoplasm Staging , Obesity, Morbid/complicationsABSTRACT
Several thousands of laparoscopic mini-gastric bypass have been performed globally by a number of surgeons. There is growing evidence that mini-gastric bypass is a safe and effective procedure. We report a rare case of massive gastric remnant dilation in a 45-year-old man after laparoscopic mini-gastric bypass. Acute gastric dilatation is a surgical emergency. In our case, a triad of clinical suspicion, laboratory profile, and emergency radiologic investigation were essential for early diagnosis and management. Image-guided gastrostomy tube placement provides an effective decompression of the gastric remnant. A literature review revealed no previous reports of similar complications in mini-gastric bypass.
