Comparison of metabolic effect improvements after different bariatric surgery

• Main Authors: Ming-Hsien Lee, 李旻憲
• Other Authors: Ming-Chih Chou
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/96752182885768670609

碩士 === 中山醫學大學 === 醫學研究所 === 101 === Background : Morbid obesity is a worldwide problem now. It is associated with hypertension, hyperlipidemia, type II diabetes and other metabolic diseases. Bariatric surgery is gaining acceptance due to operative procedure development from open surgery to laparoscopic surgery and its safety. Bariatric surgery is gaining acceptance too as a ''metabolic surgical intervention'' for patients with type 2 diabetes. The optimal form of surgery and the mechanism of action of these procedures are much debated. We compared two bariatric procedures for obese patients with type 2 diabetes and evaluated their effects on HbA1c and glucose tolerance and other metabolic effects. Methods: This study is a retrospective study. We performed laparoscopic Roux-en-Y gastric bypassvslaparoscopic sleevegastrectomy in 126obese patients, who were bariatric surgery candidates attending the obesity clinic. HbA1c, body composition, glucose tolerance and lipid profile were evaluated at baseline, and at 1, 3, 6 and 12 months. Besides intra-operative parameters were recorded too, including blood loss, complication, mortality, and pain score. Results: Of the 126 patients, 89 completed the follow-up (48 RYGB, 41 SG). The body weight decreasing is better in laparoscopic Roux-en-Y gastric bypass group. Resolution rate of diabetes and hypercholesterolemia has the same result. Both grouphave no mortality and major complications. But the occurrence rate of gastroesophageal reflux disease is high in laparoscopic sleeve gastrectomy group. Conclusion: In this study, both groups are safe, less complication and effective in weight loss. Laparoscopic sleeve gastrectomy can be a sole operation. But laparoscopic Roux-en-Y gastric bypass is still better in metabolic resolution effects and weight loss outcome. The high incidence of gastroesophageal reflux disease in laparoscopic sleeve gastrectomy are noted. In this study, we only have short term follow-up period, we need long term follow-up these two groups.