Gastric Bypass, Duodenum Exclusion Effective in Diabetes

And, Roux-en-Y gastric bypass risk-benefit profile may beat that of laparoscopic gastric banding

TUESDAY, Feb. 22 (HealthDay News) -- Gastric bypass surgery with duodenum exclusion is more likely than sleeve gastrectomy without duodenum exclusion to result in remission of type 2 diabetes, according to a study published in the February issue of the Archives of Surgery. According to a related article in the same issue, laparoscopic Roux-en-Y gastric bypass (RYGB) has a better risk-benefit profile than laparoscopic gastric banding.

Wei-Jei Lee, M.D., Ph.D., of Min-Sheng General Hospital in Taiwan, and colleagues observed 30 moderately obese patients with type 2 diabetes who received gastric bypass with duodenum exclusion, and 30 who received sleeve gastrectomy without duodenum exclusion, to determine the effect of the two bariatric procedures on remission of type 2 diabetes. Remission was achieved in 93 percent of the bypass group and 47 percent of the sleeve group. The researchers concluded that duodenum exclusion should be assessed for its role as a type 2 diabetes treatment.

Guilherme M. Campos, M.D., of the University of California in San Francisco, and colleagues compared 100 morbidly obese patients who received laparoscopic gastric banding with 100 patients who received laparoscopic RYGB. The researchers were looking for complications, reoperations, and outcomes at one year. They found complications similar between the two groups, but weight loss, diabetes resolution, and quality of life measures were superior in the RYGB group.

"When performed in high-volume centers by expert surgeons, RYGB has a similar rate of overall complications and lower rate of reoperations than laparoscopic gastric banding. With the benefit of greater weight loss, increased resolution of diabetes, and improved quality of life, RYGB, in these circumstances, has a better risk-benefit profile than laparoscopic gastric banding," Campos and colleagues conclude.

Abstract - Lee
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Abstract - Campos
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