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Sleeve Gastrectomy with Braun Anastomosis Transit Bipartition (B-TB): a Potential Midway Between Single Anastomosis and Roux-en-Y Transit Bipartition

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Abstract

Purpose

The single anastomosis sleeve ileal bypass (SASI) procedure is a simple modification of the Roux-en-Y transit bipartition (RYTB) procedure; however, SASI risks patients with possible biliary reflux. Braun anastomosis has been proposed to fix the biliary reflux of single anastomosis procedures. This study presented our early “sleeve gastrectomy with Braun anastomosis Transit Bipartition” (B-TB) outcomes.

Materials and Methods

Patients who underwent B-TB or RYTB between June 2020 and April 2021 at our hospital and have completed three months follow-up were included in this study.

Results

Ten patients with B-TB and forty patients with RYTB were included. No significant differences were observed between the B-TB and RYTB patients regarding the preoperative conditions. The B-TB procedure had significantly shorter operation time and postoperative hospitalization time than the RYTB procedure. There was no significant difference between the two groups regarding the 3-month percentage of total weight loss (B-TB vs RYTB: 19.7 ± 2.7% vs 22.2 ± 5.4%) and the postoperative complications before discharge. Preoperatively, two patients and eight patients achieved GERD-Q score ≥8 for the B-TB and RYTB group, respectively. At postoperative 3 months, those with GERD-Q score ≥8 was reduced to one patient and two patients for the B-TB and RYTB group, respectively. No patients have reported symptoms of greenish-yellow vomiting in both groups postoperatively.

Conclusion

B-TB is an exciting procedure with potential benefits. However, as it is an investigational procedure, extra care should be maintained. Larger samples and more extended follow-up data are needed in the future.

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Author information

Author notes

  1. Jason Widjaja and Xia Sun contributed equally for this study.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People’s Republic of China

    Jason Widjaja, Xia Sun, Yuxiao Chu, Jian Hong, Libin Yao & Xiaocheng Zhu

Authors
  1. Jason Widjaja
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  2. Xia Sun
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  3. Yuxiao Chu
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  4. Jian Hong
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  5. Libin Yao
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  6. Xiaocheng Zhu
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Corresponding author

Correspondence to Xiaocheng Zhu.

Ethics declarations

Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of the Affiliated Hospital of Xuzhou Medical University (XYFY2020-JS003-01).

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Jason Widjaja declares that he has no conflict of interest.

Xia Sun declares that she has no conflict of interest.

Yuxiao Chu declares that he has no conflict of interest.

Jian Hong declares that he has no conflict of interest.

Libin Yao declares that he has no conflict of interest.

Xiaocheng Zhu declares that he has no conflict of interest.

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Key points

1. Braun anastomosis transit bipartition (B-TB) has significantly shorter operation time than the Roux-en-Y transit bipartition (RYTB), which is an advantage especially for high-risk patients.

2. With the addition of Braun anastomosis, the incidence/severity of the bile reflux (in the single anastomosis model) could be potentially reduced with B-TB procedure.

3. Although more extended follow-up data will be needed, short-term bariatric outcomes between the B-TB and RYTB did not differ significantly.

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Widjaja, J., Sun, X., Chu, Y. et al. Sleeve Gastrectomy with Braun Anastomosis Transit Bipartition (B-TB): a Potential Midway Between Single Anastomosis and Roux-en-Y Transit Bipartition. OBES SURG 31, 5500–5503 (2021). https://doi.org/10.1007/s11695-021-05756-5

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  • DOI: https://doi.org/10.1007/s11695-021-05756-5

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