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A Prospective Single-Arm Trial of Modified Long Biliopancreatic and Short Alimentary Limbs Roux-En-Y Gastric Bypass in Type 2 Diabetes Patients with Mild Obesity.
Murad, Abdon José; Cohen, Ricardo Vitor; de Godoy, Eudes Paiva; Scheibe, Christian Lamar; Campelo, Giuliano Peixoto; Ramos, Almino Cardoso; de Lima, Roclides Castro; Pinto, Luís Eduardo Veras; Coelho, Daniel; Costa, Hamilton Belo França; Pinto, Ígor Marreiros Pereira; Pereira, Tiago; Teófilo, Francisco Raúl Santos; Valadão, José Aparecido.
Afiliación
  • Murad AJ; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil. abdonjunior@uol.com.br.
  • Cohen RV; The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil.
  • de Godoy EP; Surgical Clinic Unit, Onofre Lopes University Hospital, Natal, Brazil.
  • Scheibe CL; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil.
  • Campelo GP; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil.
  • Ramos AC; Gastro-Obeso-Center Advanced Institute for Digestive and Bariatric Surgery, São Paulo, Brazil.
  • de Lima RC; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil.
  • Pinto LEV; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil.
  • Coelho D; Service for Obesity and Related Diseases Surgery, Surgical Clinic Unit, Onofre Lopes University Hospital, Natal, Brazil.
  • Costa HBF; Service for Bariatric Surgery, Gastro Clínica, Campina Grande, Brazil.
  • Pinto ÍMP; Service for Obesity and Related Diseases Surgery, Surgical Clinic Unit, Onofre Lopes University Hospital, Natal, Brazil.
  • Pereira T; Technology and Healthcare Unit, Oswaldo Cruz German Hospital, São Paulo, Brazil.
  • Teófilo FRS; Federal University of Maranhão, São Luís, Brazil.
  • Valadão JA; Center for Bariatric and Metabolic Surgery, São Domingos Hospital, São Luís, Brazil.
Obes Surg ; 28(3): 599-605, 2018 03.
Article en En | MEDLINE | ID: mdl-28933045
BACKGROUND: Type-2 diabetes (T2D) patients with body mass index (BMI) below 35 kg/m2 carry lower remission rates than severely obese T2D individuals submitted to "standard limb lengths" Roux-en-Y gastric bypass (RYGB). Mild-obese patients appear to have more severe forms of T2D, where the mechanisms of glycemic control after a standard-RYGB may be insufficient. The elongation of the biliopancreatic limb may lead to greater stimulation of the distal intestine, alterations in bile acids and intestinal microbiota, among other mechanisms, leading to better metabolic outcomes. The aim of this study is to evaluate the safety and efficacy of the RYGB with a biliopancreatic limb of 200 cm in the control of T2D in patients with BMI 30-35 kg/m2. METHODS: From January 2011 to May 2015, 102 T2D patients with BMI from 30 to 34.9 kg/m2 underwent laparoscopic RYGB with the biliopancreatic-limb of 200 cm and the alimentary-limb of 50 cm. RESULTS: There were no deaths or reoperations. The mean follow-up was 28.1 months. The mean BMI dropped from 32.5 to 25.1 kg/m2, while the mean fasting glucose decreased from 182.9 to 89.8 mg/dl and the mean glycated hemoglobin (HbA1c) went from 8.7 to 5.2%. During follow-up, 92.2% had their T2D under complete control (HbA1c < 6%, no anti-diabetic medications), while 7.8% were under partial control. Control of hypertension and dyslipidemia were 89.4 and 85.5%, respectively. No patient developed hypoalbuminemia, and there were mild micronutrient deficiencies. CONCLUSIONS: RYGB with long-biliopancreatic and short-alimentary limbs is safe and seems effective in achieving complete control of T2D in patients with BMIs between 30 and 35 kg/m2.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación Gástrica / Diabetes Mellitus Tipo 2 / Obesidad Tipo de estudio: Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación Gástrica / Diabetes Mellitus Tipo 2 / Obesidad Tipo de estudio: Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos