Langenbeck's archives of surgery · 2023
OAGB with shortened excluded ileal loop as an effective treatment for type 2 diabetes mellitus in the cases of Caucasian men and women with obesity of the first degree (BMI 30-35 kg/m2).
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Jaworski Paweł, Binda Artur, Barski Krzysztof, Wawiernia Karolina, Kudlicka Emilia, Wąsowski Michał, Jankowski Piotr, Tarnowski Wiesław
Аннотация
INTRODUCTION: The aim of the study is to assess the effect of shortening the excluded loop of the small intestine to 150 cm on the effectiveness of one anastomosis gastric bypass (OAGB) in remission of type 2 diabetes with Io obesity.
MATERIAL AND METHODS: The study included 25 patients with a body mass index (BMI) 30-35 kg/m2, with a diagnosis of diabetes mellitus type 2 (T2DM), and undergoing OAGB with excluded 150 cm of the small intestine.
RESULTS: There were no deaths in the study group, bleeding during the postoperative period requiring reoperation, anastomotic leakage/leakage throught mechanical stitching. The mean a glycated haemoglobin (HbA1C) level 12 months after surgery was 6.16 ± 0.96%, corresponding to a 2.29 ± 3.3% decrease. In more than 85% of the patients taking insulin before surgery, the insulin was discontinued in the postoperative period. Additionally, the level of glycaemia was assessed in patients on the day of surgery (163 ± 58 mg/dl) and on the day of discharge from the hospital (4.7 ± 1.3 days)-it was lower by over 18% (133 ± 39.2 mg). Over the period of 12 months following OAGB, there was a reduction in the mean BMI value from 33.5 ± 2 to 25.5 ± 2.5 kg/m2 and improvement in lipid parameters and mean values of blood pressure.
CONCLUSION: OAGB with excluded 150 cm of the small intestine has beneficial effect on the remission of T2DM in patients with a BMI of 30-35kg/m2 and is associated with an acceptable level of complications. The achieved weight loss after surgery is satisfactory.
MATERIAL AND METHODS: The study included 25 patients with a body mass index (BMI) 30-35 kg/m2, with a diagnosis of diabetes mellitus type 2 (T2DM), and undergoing OAGB with excluded 150 cm of the small intestine.
RESULTS: There were no deaths in the study group, bleeding during the postoperative period requiring reoperation, anastomotic leakage/leakage throught mechanical stitching. The mean a glycated haemoglobin (HbA1C) level 12 months after surgery was 6.16 ± 0.96%, corresponding to a 2.29 ± 3.3% decrease. In more than 85% of the patients taking insulin before surgery, the insulin was discontinued in the postoperative period. Additionally, the level of glycaemia was assessed in patients on the day of surgery (163 ± 58 mg/dl) and on the day of discharge from the hospital (4.7 ± 1.3 days)-it was lower by over 18% (133 ± 39.2 mg). Over the period of 12 months following OAGB, there was a reduction in the mean BMI value from 33.5 ± 2 to 25.5 ± 2.5 kg/m2 and improvement in lipid parameters and mean values of blood pressure.
CONCLUSION: OAGB with excluded 150 cm of the small intestine has beneficial effect on the remission of T2DM in patients with a BMI of 30-35kg/m2 and is associated with an acceptable level of complications. The achieved weight loss after surgery is satisfactory.