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Metabolic Surgery Comparing Sleeve Gastrectomy with Jejunal Bypass and Roux-en-Y Gastric Bypass in Type 2 Diabetic Patients After 3 Years

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Abstract

Introduction

Sleeve gastrectomy with jejunal bypass (SGJB) and Roux-en-Y gastric bypass (RYGB) has shown good results with respect to type 2 diabetes mellitus (T2D) remission in our institution. In this study, we compared the efficacy and safety of SGJB versus RYGB in terms of T2D remission up to 3 years postoperatively.

Materials and Methods

A retrospective cohort study of two groups of patients with T2D who underwent SGJB or RYGB. All patients were matched by age, presurgical body mass index (BMI), glycated hemoglobin (HbA1c), and diabetes duration. Complete remission was defined as HbA1c of < 6%, fasting plasma glucose (FPG) of < 100 mg/dL, and no antidiabetic drugs.

Results

In total, 57 and 55 patients in the SGJB and RYGB groups, respectively, met the inclusion criteria. The diabetes remission rate was similar between the SGJB and RYGB groups at 1 year postoperatively (69.2 vs. 64.7%) and 3 years postoperatively (56.1 vs. 58.8%). There were no significant differences in HbA1c or FPG at 1 or 3 years between the two groups. Additionally, weight loss and other metabolic parameters were similar between the groups. Clinical chemistry values were similar at 12 months except for hematocrit and calcium, which were significantly lower in the RYGB group. There were no differences in surgical complications.

Conclusions

Both procedures showed similar results in terms of T2D remission and other metabolic markers at 3 years. Hematocrit and calcium were significantly higher in the SGJB than RYGB group. SGJB is as effective and safe as RYGB in obese patients with T2D.

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Authors and Affiliations

  1. Bariatric and Metabolic Surgery Center, Dipreca Hospital, Vital Apoquindo 1200, Las Condes, Santiago, Chile

    Matías Sepúlveda & Yudith Preiss

  2. Escuela de Medicina, Universidad Diego Portales, Santiago, Chile

    Matías Sepúlveda

  3. Hospital El Carmen, Camino A Rinconada 1201, Maipú, Santiago, Chile

    Munir Alamo

  4. Facultad de Medicina – Odontología, Universidad de Antofagasta, Badajoz 100, Las Condes, Santiago, Chile

    Juan P. Valderas

Authors
  1. Matías Sepúlveda
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  2. Munir Alamo
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  4. Juan P. Valderas
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Correspondence to Matías Sepúlveda.

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Sepúlveda, M., Alamo, M., Preiss, Y. et al. Metabolic Surgery Comparing Sleeve Gastrectomy with Jejunal Bypass and Roux-en-Y Gastric Bypass in Type 2 Diabetic Patients After 3 Years. OBES SURG 28, 3466–3473 (2018). https://doi.org/10.1007/s11695-018-3402-x

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