Clinical application of laparoscopic Roux-en-Y gastric bypass in patients with type 2 diabetes mellitus / 中华内分泌外科杂志

ABSTRACT

Objective To evaluate the clinical effects of the laparoscopic Roux-en-Y gastric bypass (LRYGB) on patients with type 2 diabetes mellitus (T2DM).Methods From Dec.2013 to Dec.2015,83 cases with T2DM received LRYGB were enrolled to this study.They were divided into low body mass index group (LBMI,25≤BMI＜28),intermediate body mass index group (IBMI,28≤BMI＜32) and high body mass index group (HBMI,BMI≥33).Meanwhile,the clinical effects and side-effects were evaluated among three groups.The factors of adverse effects were evaluated by Cox multivariate analysis.Results Only one patient in HBMI was conversed to open surgery,all the others received LRYGB.The surgery time,intraoperative blood loss and complica tion were positively related to BMI,and the difference was statistically significant between the 3 groups(P＜0.05).The main side-effect of LRYGB was gastrointestinal reaction.The level of fasting blood-glucose,postprandial 2 hours blood sugar,HbA1c and cholesterol total in three groups were lower than baseline (P＜0.05),however,there was no significant difference among the three groups (P＞0.05).The rate of clinical effects in three groups was 89.5％,89.3％ and 91.7％.There was no significant difference among the three groups(P＞0.05);In Cox multivariate analysis,cholesterol total and BMI were independent prognostic indicator for LRGB adverse.Conclusions LRYGB is a safe and effective method for patients with T2DM,which can effectively improve glucose and lipid metabolism.The increased BMI can increase the incidence of LRYGB complications.Total cholesterol is an independent prognostic indicator for the adverse of LRYGB.