Application value of the clinical curative effect for laparoscopic sleeve gastrectomy with duodeno-jejunal bypass to treat non-obese type 2 diabetes

doi:10.3877/cma.j.issn.2095-9605.2015.01.005

Abstract

Abstract:

Objective

To explore the clinical effectiveness and safety of laparoscopic sleeve gastrectomy-duodenojejunal bypass (LSG+DJB) in the non-obese diabetes patients.

Methods

The data of 12 non-obese patients with type 2 diabetes mellitus who underwent LSG+DJB from June 2012 to December 2013 were analyzed, including the length of hospitalization, operative time, blood loss, operative related complications and weight, BMI, waist circumference, fasting plasma glucose (FPG), oral glucose tolerance test, HbA1c, blood lipids and the changing of diabetes complications at pre and postoperative time of 1,3,6 and 12 months.

Results

All the procedures were preformed smoothly without perioperative death. Esophageal reflux symptoms such as heartburn happened to one case after the procedure, and released after conservative treatment. The FPG, HbA1c, HOMA-IR, C-peptide, weight, BMI, waist circumference, serum triglyceride(TG), low density lipoprotein cholesterol (LDL-C) of the patients were declined significantly after the procedure (P＜0.05). One year after the procedures, 9 cases stopped taking medicine because of the remission of T2DM, including 3 cases completely cured (HbA1c＜6.0%) and 6 cases controlled (HbA1c＜7.0%), and the other 3 cases decreased hypoglycemic agent.

Conclusions

LSG+DJB performed safely in non-obese patients with type 2 diabetes with the good effectiveness of controlling weights, improving blood glucose,blood lipid and related complications. The short-term effectiveness is good, but the long-term effectiveness remains further observation.

Key words: Laparoscopic sleeve gastrectomy- duodenojejunal bypass, Diabetes mellitus, Type 2, Treatment outcome

Jun Yin, Zhongqi Mao, Lu Xu, Zheng Zhu, Xin Chen, Xiaojun Zhou, Haixin Qian. Application value of the clinical curative effect for laparoscopic sleeve gastrectomy with duodeno-jejunal bypass to treat non-obese type 2 diabetes[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2015, 01(01): 16-20.

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References 16

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观察时间	BMI（kg/m²）	体重（kg）	腰围（cm）	FPG（mmol/L）	HbA1c（%）
术前	25.0±2.7	68±13	88±6	8.5±2.7	9.0±1.9
术后1个月	23.3±3.7*	63±13*	82±9*	7.0±1.4	7.4±1.0*
术后3个月	22.1±3.2*	59±12*	79±8*	6.7±1.0	6.9±1.4*
术后6个月	21.5±2.5*	58±12*	78±8*	6.3±1.0*	6.6±0.8*
术后12个月	21.2±2.3*	57±10*	76±8*	6.2±0.9*	6.4±0.6*
t值	8.615	6.486	6.265	2.976	4.441
P值	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05
观察时间	C肽（μg/L）	HOMA-IR	I_peak/I₀	TG（mmol/L）	HDL-C（mmol/L）	LDL-C（mmol/L）
术前	2.4±0.9	4.7±4.7	2.7±1.7	3.1±2.8	1.1±0.3	2.3±0.6
术后1个月	2.3±0.9	3.3±2.1*	-	1.7±0.8	1.2±0.4	2.6±0.6
术后3个月	2.1±0.9	2.2±1.3*	-	1.5±1.1*	1.1±0.3	2.4±0.7
术后6个月	1.9±0.7*	2.2±1.5*	7.2±8.3*	1.2±1.1*	1.3±0.3*	2.3±0.7
术后12个月	1.7±0.6*	1.7±1.6*	10.0±8.4*	0.9±0.4*	1.4±0.2*	2.2±0.5
t值	3.881	3.166	4.346	3.122	3.791	1.733
P值	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05	＞0.05

观察时间	BMI（kg/m²）	体重（kg）	腰围（cm）	FPG（mmol/L）	HbA1c（%）
术前	25.0±2.7	68±13	88±6	8.5±2.7	9.0±1.9
术后1个月	23.3±3.7*	63±13*	82±9*	7.0±1.4	7.4±1.0*
术后3个月	22.1±3.2*	59±12*	79±8*	6.7±1.0	6.9±1.4*
术后6个月	21.5±2.5*	58±12*	78±8*	6.3±1.0*	6.6±0.8*
术后12个月	21.2±2.3*	57±10*	76±8*	6.2±0.9*	6.4±0.6*
t值	8.615	6.486	6.265	2.976	4.441
P值	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05
观察时间	C肽（μg/L）	HOMA-IR	I_peak/I₀	TG（mmol/L）	HDL-C（mmol/L）	LDL-C（mmol/L）
术前	2.4±0.9	4.7±4.7	2.7±1.7	3.1±2.8	1.1±0.3	2.3±0.6
术后1个月	2.3±0.9	3.3±2.1*	-	1.7±0.8	1.2±0.4	2.6±0.6
术后3个月	2.1±0.9	2.2±1.3*	-	1.5±1.1*	1.1±0.3	2.4±0.7
术后6个月	1.9±0.7*	2.2±1.5*	7.2±8.3*	1.2±1.1*	1.3±0.3*	2.3±0.7
术后12个月	1.7±0.6*	1.7±1.6*	10.0±8.4*	0.9±0.4*	1.4±0.2*	2.2±0.5
t值	3.881	3.166	4.346	3.122	3.791	1.733
P值	＜0.05	＜0.05	＜0.05	＜0.05	＜0.05	＞0.05

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