Short-Term Outcomes of Sleeve Gastrectomy plus Jejunojejunal Bypass: a Retrospective Comparative Study with Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Chinese Patients with BMI ≥ 35kg/m2.

Abstract

Bariatric surgery represents the most effective treatment for obesity and its related comorbidities. The present study aims to evaluate the efficacy and safety of sleeve gastrectomy plus jejunojejunal bypass (SG + JJB). This retrospective study included 244 obese patients with BMI ≥ 35kg/m2 undergoing SG + JJB (n = 83), SG (n = 82), and Roux-en-Y gastric bypass (RYGB) (n = 79). Postoperative weight loss, metabolic outcomes, nutrition status, and patients' complaints at 1-year follow-up were compared. Subgroup analyses (36 pairs of SG + JJB/SG and 37 pairs of SG + JJB/RYGB) were performed to compare weight loss and lipid profiles after matching with gender, age, and BMI. In subgroup case-matched study, SG + JJB exhibited superior weight loss effect to SG regarding total weight loss (38.8 ± 8.7% vs 35.0 ± 6.1%, P = 0.011) and excessive weight loss (95.3 ± 20.4% vs 86.9 ± 13.7%, P = 0.033) at 1-year follow-up. The postoperative metabolic outcomes, nutritional status, and patients' complaints were similar between SG + JJB and SG. SG + JJB yielded similar weight loss, T2DM remission, and hypertension resolution to RYGB at 1-year follow-up, but less postoperative complications than RYGB regarding anemia (4.8% vs 22.8%), vitamin D deficiency (47.0% vs 65.8%), vitamin B12 deficiency (8.4% vs 25.3%), hypoalbuminemia (1.2% vs 8.9%), diarrhea (6.0% vs 21.5%), dumping syndrome (0 vs 7.6%), and fatigue (25.3% vs 40.5%) (P < 0.05). In subgroup case-matched study, RYGB improved total cholesterol and low-density lipoprotein better than SG + JJB (P < 0.05). In short-term follow-up, SG + JJB offered better weight loss than SG and similar weight loss to RYGB. SG + JJB resulted in less postoperative nutritional deficiency and complications than RYGB except for lipid and hypertension improvement.