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Laparoscopic Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass in The Remission of Type 2 Diabetes Mellitus:

Early Results From A Bariatric Centre in Malaysia.

Author: Anivat Ai Pun, Loo Guo Hou, Reynu Rajan, Nik Ritza Kosai, Norlela Sukor

Category: JMSR Surgery


Background: Obesity is strongly associated with Type 2 diabetes mellitus (T2DM). Gastric bypass results in remission of T2DM. Sleeve gastrectomy has been shown to have comparable effects on T2DM resolution. We compared the outcomes of laparoscopic sleeve gastrectomy (LSG) with laparoscopic Roux-en-Y gastric bypass (LRYGB) on T2DM, dyslipidaemia, hypertension and body mass index (BMI) in obese patients with T2DM. Material and Methods: A retrospective chart review was performed on patients above 18years old with T2DM who underwent LSG or LRYGB in our university hospital from January 2012 to June 2017. Post-operative weight and metabolic parameters a year after surgery were collected and analyzed. Results: 167 (LSG:89, LRYGB:78) patients were included. At one year after surgery, 74.2% and 76.9% of patients in the LSG and LRYGB group had HbA1C< 6.1% respectively. Complete remission of T2DM was seen in 52.8% of patient after LSG and 58.9% after LRYGB (p=0.321). HbA1c decreased to 5.74% (?0.8) in LSG group and 5.67% (?0.8) in LRYGB group (p=0.559). Significant BMI reduction was seen in both groups [LSG: 35.2(?7.6), LRYGB 31.2(?7.2), p=0.001]. All patients experienced improvement in lipid profile post operatively. Conclusion: Bariatric surgery results not only in significant weight loss one year after surgery but also in improvement of metabolic disease in the Malaysian population. longer follow-up is required to assess if this effect persists beyond a year.

Keywords: Metabolic surgery, Obesity, Asian population, minimal access surgery, HbA1c


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