Application value of laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis in treating obesity

Abstract

Objective To investigate the clinical application value of laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG) in treating obesity. Methods Clinical data of 18 obese patients undergoing metabolic surgery in the Department of Diabetic and Bariatric Surgery in Dongfang Hospital Affiliated to Tongji University between March 2014 and April 2016 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the JI-LSG group and the laparoscopic sleeve gastrectomy (LSG) group according to different surgical approaches. Among the 9 patients of JI-LSG group, 5 were males and 4 were females with an average age of (31±9) years old. Among the 9 patients of LSG group, 5 were males and 4 were females with an average age of (31±10) years old. Operation time, intraoperative blood loss, postoperative hospital stay, postoperative complication and body mass index (BMI) loss, percentage of excess body weight loss (EWL%) and metabolic disease remission in 6 months after surgery were compared between the two groups. Clinical indexes between the two groups were compared using t test and Fisher’s exact test. Results The complications incidence of JI-LSG group patients was 33% (3/9), which had no statistical difference with 22% (2/9) of LSG group (P=0.599). At 6 months after surgery, the BMI loss and EWL% in JI-LSG group were (15±6) kg/m2 and (76±27)% respectively, which were significantly higher than (10±5) kg/m2 and (54±29)% of LSG group respectively (t=4.60, 4.18, P<0.05). The obesity-related complications of the two group patients all got significantly improved. Conclusions JI-LSG is not difficult to be performed, and has a good effect on obesity and metabolic diseases, but it is still in the early stage of application, so remains to be further investigated for its value. Key words: Obesity; Laparoscopic sleeve gastrectomy plus side-to-side jejunoileal anastomosis; Laparoscopic sleeve gastrectomy; Treatment outcome