Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: a promising operation.

BACKGROUND

The continuing need for simple, safe, and effective procedures led us to design a new operation for treating morbid obesity.

METHODS

Thirty-two patients underwent our novel procedure, sleeve gastrectomy plus side-to-side jejunoileal anastomosis (SG plus), and were followed for 6 to 24 months. A matched cohort of 32 patients underwent sleeve gastrectomy over the same period and was used as the control group. Weight loss, comorbidity outcomes, and the duodenum to cecum transit time after a gastrografin swallow, performed at postoperative day 4, were compared.

RESULTS

There were no deaths and no major perioperative complications. Three patients developed long-term complications requiring surgical intervention (intestinal obstruction, nausea-vomiting, and hypoalbuminemia). In the SG plus group, a 77.8 % excess weight loss was achieved at 12 months postoperatively, which was significantly better (p < 0.01) than the 67 % observed in the control group. The comorbidity outcomes, particularly diabetes resolution, were also significantly superior in the SG plus patients. The duodenum to cecum transit time of 11 min in the SG plus group was significantly shorter (p < 0.01) than the 31 min observed in the control group.

CONCLUSIONS

Sleeve gastrectomy plus side-to-side jejunoileal anastomosis appears to be a simple, considerably safe, and effective procedure for treating obesity and its metabolic comorbidities.