Dear Rangarajan, 

Adding duodenal switch to sleeve gastrectomy increases the effect of diabetic control and metabolic syndrom resolution based on this paper:

Surg Obes Relat Dis. 2015 Jul-Aug;11(4):765-70. 

Duodenal-jejunal bypass with sleeve gastrectomy versus the sleeve gastrectomy procedure alone: the role of duodenal exclusion.

Lee WJ, Almulaifi AM, Tsou JJ, Ser KH, Lee YC, Chen SC.

Electronic address: [email protected].

Abstract

BACKGROUND:

Laparoscopic sleeve gastrectomy (SG) has become accepted as a stand-alone procedure as a less complex operation than laparoscopic duodenojejunal bypass with sleeve gastrectomy (DJB-SG).

OBJECTIVES:

The aim of this study was to compare one-year results between DJB-SG and SG.

SETTING:

University hospital.

METHODS:

A total of 89 patients who received a DJB-SG surgery were matched with a group of SG that were equal in age, sex, and body mass index (BMI). Complication rates, weight loss, and remission of co-morbidities were evaluated after 12 months.

RESULTS:

The mean preoperative patient BMI in the DJB-SG and SG groups was similar. There were more patients with type 2 diabetes mellitus (T2DM) in the DJB-SG group than in the SG group. The mean operative time and length of hospital stay (LOS) were significantly longer in the DJB-SG group than in the SG group. At 12 months after surgery, the BMI was lower and excess weight loss higher in DJB-SG than SG. Remission of T2DM was greater in the DJB-SG group. Low-density lipoprotein, total cholesterol, and metabolic syndrome (MS) improved after operation in both groups.

CONCLUSIONS:

In this study DJB-SG was superior to SG in T2DM remission, triglyceride improvement, excess weight loss, and lower BMI at 1 year after surgery. Adding duodenal switch to sleeve gastrectomy increases the effect of diabetic control and MS resolution.

Nice !! That answers my doubts, thanks Dr.Ewalds-Kvist. Now I'm wondering if LDJB+SG is similar  to Roux-en-Y gastric bypass regarding T2DM control & weight loss............................

The attached study concluded that LDJB-SG has higher remission rate and better glycemic control as compared to RYGB in patient with BMI < 35kg/m2. Table 2 gives a comparison of clinical and biochemical characteristics at 1 year post surgery between the patients who underwent LDJB-SG and RYGB from which it can be seen that late complications is 17 (mortality = 1) in the RYGB group versus 0  (0) in the other group.  

Correspondence to: dr. ckhuang@hotmail. com

http://cdn.intechopen.com/pdfs-wm/47485.pdf

Article Novel Metabolic Surgery for Type II Diabetes Mellitus: Loop ...

Dear Dr.Ewalds-Kvist,

Thanks again for that input. You seem to have all the right answers............!!

But seriously, I agree with those authors - DJ Bypass is technically easier to perform compared to Gastric bypass and if it gets good results, why not?

Its also interesting why they chose 150-200 cm as the length of the bypass limb. I wonder what the malabsorption rates are, following these 2 procedures.

Sorry Muthukumaran Rangarajan, 

Sorry these names are so complicated, I do not know what is first and what is second name. Based on the literature doe the length of the bypass limb matters. (When you move up to face surgery tell me, I want a lift:). Hope you have some joy nevertheless of these papers. 

Article Weight Gain After Short- and Long-Limb Gastric Bypass in Pat...

Article Is Weight Loss Better Sustained with Long-Limb Gastric Bypas...

Article Roux-en-Y gastric bypass: limb length and weight loss

Conference Paper NO EFFECT OF ALIMENTARY LIMB LENGTH ON WEIGHT LOSS IN ROUX-E...

Article The impact of limb length on weight loss following laparosco...

Whew !! Thanks Dr.Ewalds-Kvist, that list is exhaustive (and exhausting to read too!!)