Comparative Study between Laparoscopic Sleeve Gastrectomy and Laparoscopic Mini Gastric Bypass in Control of Type 2 Diabetes Mellitus in Obese Patients

Abstract

Background: Among morbidly obese adult patients (body mass index (BMI) <40 kg/m2) those who are super obese (BMI < 60 kg/m2) present particular challenges for bariatric surgeons. Management of super obese (SO) patient has been associated with higher morbidity and mortality and increase surgical risk. The optimal surgical management of these patients is controversial. Aim: This work aimed to focus light on super obese patient. Considering the advantages, the disadvantages and determine long-term outcome of different plans of management regarding the recent guidelines for this group of patients. Patients and Methods: This study included 60 obese patients with type 2 diabetes mellitus (DM) and randomly divided using closed envelopment method into two groups: Group (1): (30 patients) treated by laparoscopic Sleeve gastrectomy (LSG), Group (2): (30 patients) treated by laparoscopic Mini-Gastric Bypass (MGB). Results: This study included 60 obese patients with type 2 D.M. As regard all sample patients (60 obese patients with type 2 D.M), the group age ranged between 22 -55 years with a mean ± SD of 37.88 ± 9.52 years. The group BMI ranged between 37 – 72 kg/m2 with a mean ± SD of 52.42 ± 9.45 kg/m2. Of the 60 patients, 38 patients (63.3%) were women and 22 patients (36.7%) were men. Conclusion: Bariatric surgery (LSG and MGB) is not only weight reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and they are considered the most effective long term treatment modality for type 2 diabetes in obese patients and with comparing between LSG and MGB, our study suggests that MGB has better and earlier effect than LSG in diabetes remission.