Short-Term Operative Outcomes of Loop Reconstruction for Duodenojejunal Bypass With Sleeve Gastrectomy: A Retrospective Study From a Single Japanese Academic Hospital.

INTRODUCTION

Roux-en-Y duodenojejunal bypass with sleeve gastrectomy (RY-DJB-SG) generally yields better operative outcomes regarding weight loss and glycemic control compared with SG. However, the requirement of two anastomoses limits its adoption as a primary metabolic bariatric surgery in Japan. To reduce the complexity of RY-DJB-SG, we introduced loop reconstruction for DJB-SG (L-DJB-SG) with a single anastomosis in 2022. This study aimed to assess the feasibility and short-term operative outcomes of L-DJB-SG and RY-DJB-SG.

METHODS

Electronic medical records of 13 and 26 patients who underwent L-DJB-SG and RY-DJB-SG, respectively, between May 2012 and November 2023 at our institute were retrospectively analyzed. Patients' demographic characteristics and glycemic and operative outcomes were statistically compared between the two groups.

RESULTS

No significant differences in demographic data were observed between the groups. L-DJB-SG exhibited a shorter operation time (221 [206-268] vs. 304 [283-332.3] min, p < 0.01) and required fewer staplers (2 [1.5-2] vs. 5 [3-5], p < 0.01) for bypass procedures compared with RY-DJB-SG, whereas other operative outcomes were comparable. No significant differences in weight loss or glycemic parameters were noted 1 year after surgery.

CONCLUSION

L-DJB-SG is a feasible and effective procedure that may serve as an alternative DJB option for Japanese patients with obesity and diabetes mellitus.