Gastro-ileal anastomosis bypass – Exploring for an expanding surgical treatment for diabetes in patients with low body mass index: Case series

Rey Jesús Romero,Raquel Colorado-Subizar

doi:10.1016/j.ijscr.2020.01.051

Rey Jesús Romero, Raquel Colorado-Subizar

Open Access

https://doi.org/10.1016/j.ijscr.2020.01.051

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Abstract

IntroductionSeveral metabolic operations have been created in an attempt to enhance the equilibrium between safety, efficacy and costs of accessible metabolic surgery in diabetic patients with low body mass index (BMI). The purpose of this study is to present the preliminary outcomes of a novel procedure. MethodsA Gastro-Ileal Anastomosis Bypass (GIA-B) was performed in 4 diabetic patients at Boca del Rio Hospital, Veracruz, México. The study was performed between March 2018 and October 2019. GIA-B was created at point to 300 cm from ileocecal valve that was held together with gastric antrum. Outcomes are presented and discussed. At average 14.7 months follow-up all the patients improved glycated hemoglobin(A1C), decrease antidiabetic medications and lost mild weight. Two patients had complete remission of type-2 diabetes mellitus. There were no postoperative complications. ResultsGIA-B, have a considerable metabolic effect reaching improvement of the homeostatic parameters, specially A1C, in all the cases evaluated. GIA-B appears to be technically simple and the cost is considerably lower than other metabolic procedures, especially for the saving cartridges. ConclusionsGIA-B could be an alternative metabolic surgery for low-BMI diabetic patients, further studies are needed to explore this procedure.

Highlights

Several metabolic operations have been created in an attempt to enhance the equilibrium between safety, efficacy and costs of accessible metabolic surgery in diabetic patients with low body mass index (BMI)
In spite of the evidence, about 15 million people in the U.S have morbid obesity but only 1 % of the clinically eligible population is treated through bariatric surgery [1], in diabetic eligible population for metabolic surgery tendency is probably similar, being the economic factor the most important cause
Mahdy et al [2] published a new concept in metabolic surgery, the Single Anastomosis Sleeve Ileal Bypass (SASI-B) with promising results

Summary

Introduction

Several metabolic operations have been created in an attempt to enhance the equilibrium between safety, efficacy and costs of accessible metabolic surgery in diabetic patients with low body mass index (BMI). The purpose of this study is to present the preliminary outcomes of a novel procedure. METHODS: A Gastro-Ileal Anastomosis Bypass (GIA-B) was performed in 4 diabetic patients at Boca del Rio Hospital, Veracruz, México. CONCLUSIONS: GIA-B could be an alternative metabolic surgery for low-BMI diabetic patients, further studies are needed to explore this procedure. Mahdy et al [2] published a new concept in metabolic surgery, the Single Anastomosis Sleeve Ileal Bypass (SASI-B) with promising results. We took the concept of this operation, made technical changes and created, in our knowledge, a new concept, Gastro-Ileal Bypass (GIA-B). This work has been reported in line with the the PROCESS guidelines [3]

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