Obesity is a major global health problem. Bariatric surgery is the most effective treatment, leading to substantial weight loss and improvement in obesity-related comorbidities. The most commonly performed procedures are Laparoscopic Roux-en-Y gastric bypass (LRYGB) and Laparoscopic sleeve gastrectomy (LSG). LRYGB is typically selected for patients with a BMI exceeding 50 kg/m2. Recently, LSG with duodenojejunal bypass (LSG-DJB) has been introduced. To date, no randomized controlled trial has compared LRYGB and LSG-DJB in patients with super morbid obesity, particularly regarding postoperative hormonal responses. This study aims to address this gap. If LSG-DJB results in a lower incidence of post-bariatric hypoglycemia than LRYGB, it would support its clinical benefit. Evaluation of GLP-1, GIP, glucagon, and insulin responses will clarify mechanisms underlying weight loss and postprandial glycemic changes.
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primploy.gre@chulahospital.org
Sleeve gastrectomy with duodenojejunal bypass is a surgical technique in which the greater curvature of the stomach is resected and separated from the lesser curvature and antrum, reducing the gastric volume to approximately 80-150 mL (about 20% of the original capacity) using a 32-36 Fr bougie. Subsequently, the biliopancreatic limb is created by transecting the small intestine approximately 50-100 cm distal to the duodenojejunal (DJ) junction. A Roux (alimentary) limb measuring 150-200 cm in length is then constructed, followed by the creation of a duodenojejunostomy.
Roux-en-Y gastric bypass is a surgical technique in which the stomach is reduced to a small pouch with a volume of approximately 15-50 mL. The jejunum is then transected 40-50 cm distal to the duodenojejunal (DJ) junction and anastomosed to the gastric pouch to create the Roux (alimentary) limb, which is typically 75-150 cm in length. Finally, a jejunojejunostomy is performed to reconnect the small intestine.
Pathum Wan, Bangkok 10330, Thailand
primploy.gre@chulahospital.org66917142555
Patchaya.B@chula.ac.th66814416460
Comparison of Gastric Bypass and Sleeve Gastrectomy in Metabolic and Cardiovascular Indices
Randomized Comparison of Laparoscopic Sleeve Gastrectomy and Gastric Bypass for Morbid Obesity
Comparison of Laparoscopic Sleeve Gastrectomy and Roux-Y-gastric Bypass in the Treatment of Morbid Obesity
Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy