Short-Term Outcomes of Sleeve Gastrectomy plus Jejunojejunal Bypass: a Retrospective Comparative Study with Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Chinese Patients with BMI ≥ 35 kg/m2

Jan 13, 2019Obesity surgery

Short-term results of sleeve gastrectomy with jejunojejunal bypass compared to sleeve gastrectomy and Roux-en-Y gastric bypass in Chinese patients with BMI 35 or higher

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Abstract

SG + JJB resulted in 38.8 ± 8.7% total weight loss compared to 35.0 ± 6.1% with SG at 1-year follow-up.

SG + JJB showed significantly greater excessive weight loss compared to SG, with results of 95.3 ± 20.4% versus 86.9 ± 13.7%.
Postoperative metabolic outcomes and nutritional status were similar between SG + JJB and SG.
SG + JJB achieved comparable weight loss and remission rates for type 2 diabetes and hypertension to RYGB at 1-year follow-up.
SG + JJB had fewer postoperative complications related to nutritional deficiencies than RYGB, including anemia (4.8% vs 22.8%) and vitamin D deficiency (47.0% vs 65.8%).
RYGB resulted in better improvements in total cholesterol and low-density lipoprotein levels compared to SG + JJB.

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BACKGROUND: Bariatric surgery represents the most effective treatment for obesity and its related comorbidities. The present study aims to evaluate the efficacy and safety of sleeve gastrectomy plus jejunojejunal bypass (SG + JJB).

METHODS: This retrospective study included 244 obese patients with BMI ≥ 35 kg/mundergoing SG + JJB (n = 83), SG (n = 82), and Roux-en-Y gastric bypass (RYGB) (n = 79). Postoperative weight loss, metabolic outcomes, nutrition status, and patients' complaints at 1-year follow-up were compared. Subgroup analyses (36 pairs of SG + JJB/SG and 37 pairs of SG + JJB/RYGB) were performed to compare weight loss and lipid profiles after matching with gender, age, and BMI. 2

RESULTS: In subgroup case-matched study, SG + JJB exhibited superior weight loss effect to SG regarding total weight loss (38.8 ± 8.7% vs 35.0 ± 6.1%, P = 0.011) and excessive weight loss (95.3 ± 20.4% vs 86.9 ± 13.7%, P = 0.033) at 1-year follow-up. The postoperative metabolic outcomes, nutritional status, and patients' complaints were similar between SG + JJB and SG. SG + JJB yielded similar weight loss, T2DM remission, and hypertension resolution to RYGB at 1-year follow-up, but less postoperative complications than RYGB regarding anemia (4.8% vs 22.8%), vitamin D deficiency (47.0% vs 65.8%), vitamin B12 deficiency (8.4% vs 25.3%), hypoalbuminemia (1.2% vs 8.9%), diarrhea (6.0% vs 21.5%), dumping syndrome (0 vs 7.6%), and fatigue (25.3% vs 40.5%) (P < 0.05). In subgroup case-matched study, RYGB improved total cholesterol and low-density lipoprotein better than SG + JJB (P < 0.05).

CONCLUSIONS: In short-term follow-up, SG + JJB offered better weight loss than SG and similar weight loss to RYGB. SG + JJB resulted in less postoperative nutritional deficiency and complications than RYGB except for lipid and hypertension improvement.

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Short-Term Outcomes of Sleeve Gastrectomy plus Jejunojejunal Bypass: a Retrospective Comparative Study with Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Chinese Patients with BMI ≥ 35 kg/m2

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