Efficacy of Sleeve Gastrectomy with Duodenal-Jejunal Bypass for the Treatment of Obese Severe Diabetes Patients in Japan: a Retrospective Multicenter Study

Takeshi Naitoh, Kazunori Kasama, Yosuke Seki, Masayuki Ohta, Takashi Oshiro, Akira Sasaki, Yasuhiro Miyazaki, Tsuyoshi Yamaguchi, Hideki Hayashi, Hirofumi Imoto, Naoki Tanaka, Michiaki Unno

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Background: The incidence of obesity with type 2 diabetes (T2DM) is increasing in Japan. The main bariatric surgery procedures in Japan are laparoscopic sleeve gastrectomy (LSG) and LSG with duodenal-jejunal bypass (LSG/DJB) because of the high incidence of gastric cancer and difficulty exploring a remnant stomach after gastric bypass. However, few studies have compared the antidiabetic effect of LSG/DJB with LSG alone. Purpose: The purpose of this study is to compare the antidiabetic effect of LSG/DJB with that of LSG alone in Japanese obese diabetic patients. Methods: This was a retrospective multicenter study including 298 cases: 177 and 121 LSG and LSG/DJB cases, respectively. We investigated the antidiabetic effect of these two procedures at 12 months after surgery. Univariate and multivariate analyses were done to evaluate the predictive factors of T2DM remission. Results: The diabetes remission rate at 12 months after surgery was 80.8% for LSG and 86.0% for LSG/DJB. Insulin use and HbA1c ≤ 6.7% were significant predictive factors in multivariate analysis for all patients. In patients with ABCD score ≥ 6, the diabetes remission rate was 94.8% and there was no difference between procedures. Only duration of diabetes and insulin use were significant predictive factors both in univariate and multivariate analyses. However, in cases with ABCD score ≤ 5, the remission rate was 70.3% and procedure type was the most significant predictive factor for diabetes remission (odds ratio [OR] 5.140). Conclusions: Although both LSG and LSG/DJB have good antidiabetic effects in Japanese obese patients, LSG/DJB is more effective for patients with lower ABCD scores.

Original languageEnglish
Pages (from-to)497-505
Number of pages9
JournalObesity Surgery
Volume28
Issue number2
DOIs
Publication statusPublished - 2018 Feb 1

Keywords

  • Bariatric surgery
  • Diabetes mellitus
  • Metabolic surgery
  • Morbid obesity
  • Sleeve gastrectomy with duodenal-jejunal bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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