Laparoscopic gastric bypass surgery with a single anastomosis: a comparative analysis of the metabolic and bariatric effects

Abstract

Objective. To compare the results of the effect of long–loop, distal and mini–gastric bypass surgery with a single anastomosis on the loss of excess body weight, indicators of protein, lipid, carbohydrate metabolism, correction of metabolic syndrome and development of deficiency states after 36 months. Materials and methods. Patients with morbid obesity were divided into 3 groups: Group 1 – 25 patients who underwent long–loop gastric bypass with a biliopancreatic loop length of 200 cm; Group 2 – 25 patients who underwent mini–gastric bypass with a biliopancreatic loop length of 200 cm using laparoscopic access; Group 3 – 25 patients who underwent distal gastric bypass with a total loop length of 250 cm. Results. 36 months after the operation, the loss of excess body weight was (69 ± 1.1)% in group 1, (70.1 ± 1.3)% in group 2 and (72 ± 0.9)% in group 3; remission of dyslipidaemia was observed in 4 (80%) of 5 patients in group 1, 11 (84.6%) of 13 patients in group 2 and 7 (100%) of 7 patients in group 3; remission of type II diabetes mellitus – in 3 (75%) out of 4, 5 (83.3%) out of 6 and 6 (100%) out of 6 patients, respectively, complete remission of arterial hypertension – in 6 (46.2%) out of 13, 7 (50%) out of 14 and 9 (60%) out of 15 patients, respectively. Conclusions. Laparoscopic long–loop gastric bypass with a single anastomosis is effective and safe, does not cause severe deficiency states, and can be used as a primary bariatric surgery.