Published online Oct 7, 2016. doi: 10.3748/wjg.v22.i37.8398
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
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).
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.
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.
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.
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.