Comparison of Changes in Gastrointestinal Hormones after Conventional Roux-en Y Gastric Bypass versus Near Total Gastrectomy with Roux-en Y Gastric Bypass in Diabetes and Obesity Rat Model

Abstract

Purpose: Roux-en Y gastric bypass (RYGBP) surgery is effective and used worldwide for treating morbid obese patients. In Korea, RYGBP has not performed popularly due to relatively high incidence of gastric cancer because that procedure has a limitation of difficulty surveillance of remnant stomach after surgery. The aim of this study was to compare conventional RYGBP with RYGBP with near total gastrectomy (NTG) in terms of changes of gastrointestinal hormone and complications in diabetes and obesity rat model. Materials and Methods: Four ZDF/CrlCrlj-Leprfa/Leprfa (Fatty) rats were used (2 rats for each group). Changes in body weight, fasting glucose, and the serum concentrations of insulin, ghrelin, and peptide YY (PYY) were measured. Results: Body weight was decreased by 2 weeks after surgery in all rats, and maintained thereafter. All showed improved fasting glucose, but that was more improved in RYGBP with NTG group without statistically significance. Insulin declined by 69.1% and 42.8% in RYGBP and NTG with RYGBP group, respectively. Ghrelin increased by 46.5% and 27.45% and PYY by 19.58% and 24.56%. There was no operation related complication on necropsy at 4 weeks after surgery. Conclusion: Postoperative outcomes after NTG with RYGBP were comparable to those after RYGBP and glucose control after NTG with RYGBP seems to be better than that after RYGBP in this animal study. Future clinical studies in humans are warranted.