Roux-en-Y Gastric Bypass vs Vertical Sleeve Gastrectomy in the remission of type 2 Diabetes Mellitus: A Systematic Review and Metanalysis

Abstract

Objective: To determine whether Roux-en-Y gastric bypass is more effective than vertical sleeve gastrectomy in the remission of type 2 diabetes mellitus.Methods: A systematic review and meta-analysis was performed, the literature search was performed in 4 Web of Science, Medline/PubMed, Embase, Scopus and Medline/Ovid databases, 1323 results were identified, followed by screening and 14 articles selected and included in the systematic review were obtained. Primary and secondary outcomes were measured through an RR with a 95% CI.Results: The primary outcome of T2DM remission was 15% in favor of VSG, RR: 1.15; [95% CI: 1.04 – 1.28]. For secondary outcomes, hypertension remission was 7% in favor of RR VSG: 1.07; [95% CI: 1.00 – 1.16]. Remission of dyslipidemia was 16% in favor of RR VSG: 1.16; [ 95% CI: 1.06 – 1.26]. BMI after surgery was in favor of RYGB MD: -1.31; [95% CI: -1.98 – -0.64]. For excess weight loss was in favor of VSG with a MD: 6.50; [95% CI: 4.99 – 8.01]. In relation to total cholesterol, they were favorable for RYGB in 65% MD: -0.35; [95% CI: -0.46 – -0.24], with a value of p<0.05. For LDL values our results were favorable for RYGB at 69% MD: -0.31; [95% CI: -0.45 – -0.16], p<0.01 value.Conclusion: Laparoscopic sleeve gastrectomy is more effective in DM2 remission, hypertension remission, dyslipidemia remission, weight loss compared to Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is more effective in lowering BMI, lowering total cholesterol, LDL and TG compared to laparoscopic sleeve gastrectomy.