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Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for type 2 diabetes patients

Ke Gong, Nengwei Zhang, MD, Bin Zhu, Jirun Peng, MD, Dexiao Du, MD, Amin Buhe, MD. Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Objective: To compare the effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) with laparoscopic sleeve gastrectomy (LSG) to treat type 2 diabetes (T2DM) patients.

Methods: 44 patients suffering from T2DM were enrolled in this study in Beijing Shijitan Hospital during March 2012 to March 2016. The patients were divided into LRYGB group (n=24) or LSG group (n=20) based on the surgical procedure and the clinic data of two group were collected and compared.

Results: All patients suffered from T2DM undertook LRYGB surgery or LSG surgery successfully. The average levels of fasting blood sugar (FBS) and glycosylated hemoglobin (HbAlc) of 44 patients before surgery were 9.17±3.29 mmol/L, 7.99%±1.88% respectively. The mean body mass index (BMI) of them was 39.10±6.56 kg/m2 before surgery. There were no significant difference in the mean FBS, HbAlc and BMI in two groups (P>0.05).The average levels FBS and HbAlc of all patients at 1, 12 months after surgery were lower than those before surgery (2.98±2.60mmol/L , P=0.000, 3.00±2.62mmol/L, P=0.000;1.86%±1.74%, P=0.000, 1.90%±1.70%,P=0.000). The mean BMI of all patients was decreased significantly at 12 months after surgery (P<0.05) and the mean excess weight loss(EWL%)was 80.61%±20.06%(74.52%~86.71%)at 12 months after surgery. The average operating time for the patients in LRYGB group was significantly longer compared to LSG group (107.9±16.1min vs. 92.0±26.1min,P=0.008), but there were no significant difference in the mean operative bleeding,hospital stay and the recovery time in two groups (P>0.05). Although the mean HbAlc of the patients at 1, 12 months after surgery in LRYGB group were lower than those in LSG group (1.36%±0.30%, P=0.000, 1.44%±0.32%,P=0.000), there were no significant difference in the decreases including levels of FBS, the mean BMI and EWL% in two groups (P>0.05). The patients were followed up for 16~18 months, an average period of 16 months. No major complication was found in all patients.

Conclusions: This research concludes that LRYGB and LSG are safe and effective to treat the patients who suffered from type 2 diabetes. We recommend LSG as preferable choice of the surgical procedure considering easily being operated.

Keywords: Roux-en-Y gastric bypass;sleeve gastrectomy ;laparoscopic surgery; type 2 diabetes


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 77744

Program Number: P555

Presentation Session: Poster (Non CME)

Presentation Type: Poster

42

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