Laparoscopic Roux-en-Y Gastric Bypass versus Duodenojejunal Bypass Liner: Comparison of Weight Loss and Changes in Glucose Metabolism After Bariatric Surgery

Abstract

Introduction: Roux-en-Y Gastric Bypass (RYGB) and Duodenojejunal Bypass Liner (DJBL) are established bariatric procedures which have been shown to induce significant weight loss and hugely ameliorate typ II diabetes mellitus (T2DM). Since DJBL implantation effects nutrient bypass of the duodenum, its means of action is considered comparable to that of RYGB. Here, we present final data from a monocentric prospective parallel group study comparing weight loss and changes in glucose metabolism induced by each of the two bariatric procedures in patients with obesity and T2DM. Methods: Up to November 2016, a total of 45 patients were included. Twenty (6 male, mean age 51.1 ±10.9 yrs) underwent RYGB, and twenty-five DJBL (10 male, mean age 52.5 ±9.6 yrs). Body weight, BMI and glycated haemoglobin A1C (HbA1C) were documented pre-intervention and 1, 3, 9 and 12 months post-operatively. Results: Compared to preintervention, both procedures resulted in a significant improvement of body weight, BMI and metabolic parameters: RYGB (D bw -34.5kg; D BMI -11,7 g/m2; D HbA1c -1.7%); DJBL (D bw -18.9 kg; D BMI -6.5 g/m2; D HbA1c -1.7%). Changes in metabolic parameters are shown in Table 1 (*compared to pre-intervention).Table: No Caption availableConclusion: This is the first study comparing the improvement in glucose metabolism following RYGB or DJBL. As expected, our data demonstrated RYGB to be superior by inducing weight loss. However, both procedures have a similar impact on diabetes remission, indicating that alteration of weight loss itself is not the main determinant of improvement in glucose homeostasis in these obesity procedures.