Abstract
Background: There has been a rapid rise in incidence of obesity and its associated metabolic consequences in Asia where 60% of the world population resides and who are already at an elevated risk of developing diabetes. Though laparoscopic Roux-en-Y gastric bypass (LRYGB) has established itself as a standard, considering its technical difficulty and long term morbidity, there are possible alternatives being developed for equally effective but less morbid. Laparoscopic proximal jejunal bypass with sleeve gastrectomy (LPJB-SG) was first described by de Menezes in 2004 and further studies had shown it to be effective in weight loss and in remission of type 2 diabetes mellitus. Methods: Sixty five patients with obesity/uncontrolled type 2 diabetes underwent LPJB-SG between October 30th, 2014 and April 15th, 2016. This is an ongoing prospective study on Asian patients. All surgeries were performed by a single surgeon and consisted of a sleeve gastrectomy and bypassing proximal jejunum about 250–300 cm in length. Intra and post-surgical data were collected and operation time, length of hospital stay (LOS) and early complications were documented. BMI, percentage of excess weight loss (%EWL), fasting sugar and HbA1c, were assessed at 1 month and 3 monthly follow-up visits thence for a year. Surgical complications were recorded. Results: All surgeries were completed laparoscopically. The operation time was 93.13 minutes on average with a mean hospital stay of 2.2 days. The average EWL was 26.49, 44.77 and 65.87 percentages at 1, 3 and 6 months respectively. The percentage of diabetic patients achieving an HBA1c of Conclusions: LPJB-SG is a feasible, safe and effective surgery for treatment of obesity and diabetes in this first Asia short-term result. It is technically simpler to perform and is easily reproducible. Long term and randomized controlled studies comparing with other surgical procedures would be required to assess it further.
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