Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2016; 22(37): 8398-8405
Published online Oct 7, 2016. doi: 10.3748/wjg.v22.i37.8398
Application of side-to-side anastomosis of the lesser curvature of stomach and jejunum in gastric bypass
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan, Department of General Surgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Bai RX designed and supervised the study; Yan WM collected and analyzed the data, and drafted the manuscript; Li YG provided analytical oversight; Xu J and Yan M revised the manuscript for important intellectual content; Zhong ZQ offered the technical or material support; all authors have read and approved the final version to be published.
Institutional review board statement: This study was reviewed and approved by the review board of Beijing Tian Tan Hospital, Capital Medical University.
Informed consent statement: All study participants, or our legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ri-Xing Bai, MD, PhD, Department of General Surgery, Beijing Tian Tan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing 100050, China. brx5168@163.com
Telephone: +86-10-67096593 Fax: +86-10-67096593
Received: May 31, 2016
Peer-review started: June 1, 2016
First decision: July 12, 2016
Revised: July 19, 2016
Accepted: August 10, 2016
Article in press: August 10, 2016
Published online: October 7, 2016
Abstract
AIM

To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB).

METHODS

Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed.

RESULTS

All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum. No patient was switched to laparotomy during operation. No early complications including gastrointestinal anastomotic bleeding, fistula, obstruction, deep vein thrombosis, incision infections, intra-abdominal hernia complications were found. One patient complicated with stricture of gastrojejunal anastomosis (1.3%) and six patients complicated with incomplete intestinal obstruction (7.8%). BMI and HbA1c determined at 3, 6, 12, 24 mo during follow up period were significantly reduced compared with preoperative baselines respectively. The percentage of patients who maintain HbA1c (%) < 6.5% without taking antidiabetic drugs reached to 61.0%, 63.6%, 75.0%, and 63.6% respectively. The outcome parameters of concomitant diseases were significantly improved too.

CONCLUSION

Present surgery is a safety and feasibility procedure. It is effective to lighten the body weight of patients and improve type 2 diabetes and related complications.

Keywords: Laparoscopic Roux-en-Y gastric bypass, Gastric bypass, Gastrojejunostomy, Metabolic surgery, Bariatric surgery, Type 2 diabetes mellitus

Core tip: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been widely applied in the treatment of obesity patient with type 2 diabetes mellitus. Gastrojejunostomy is one of the most important procedures in LRYGB. However, the surgical mode has not been standardized. We have proved in this study that the modified side to side anastomosis of the lesser curvature of stomach and jejunum applied with linear cutting closer in LRYGB is a safe, feasible, and effective therapeutic option in the treatment of obesity patients with type 2 diabetes and complications, which could make gastrojejunostomy standardized easily in LRYGB.