Laparoscopic Duodenal–Jejunal Exclusion in the Treatment of Type 2 Diabetes Mellitus in Patients with BMI < 30 kg/m2 (LBMI)

• DOI: 10.1007/s11695-008-9759-5
• Publication Date: 2008-11-05T16:50:15Z
• Authors: Almino C. Ramos; Manoel P. Galvão ...; Yglésio Moyses de...; Manoela Galvão; Abel H. Murakami; Andrey C. Silva; Edwin G. Canseco; Raúl Santamaría; Trino A. Zambrano
• Keywords: Adult; Male; Adolescent; Middle Aged; Overweight; Body Mass Index; 3. Good health; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Diabetes Mellitus, Type 2; Jejunoileal Bypass; Duodenostomy; Humans; Female; Laparoscopy; Prospective Studies; Follow-Up Studies

The association between medical and dietetic-behavioral treatments of type 2 diabetes mellitus (T2DM) has demonstrated to have variable results. The surgical treatment of T2DM is justifiable after the observation of a successful glycemic control in patients submitted to Roux-en-Y gastric bypass and biliopancreatic diversion. Experiments have shown an important role of the proximal intestine in glycemia decrease and diabetes control.Twenty diabetic patients underwent laparoscopic duodenal-jejunal exclusion. The variables studied were body mass index (BMI), fasting glycemia, glycosylated hemoglobin (HbA1c), and C-peptide, in the preoperative period and after 3 and 6 months.There was a BMI decrease up to the third month and a weight stabilization between the third and sixth months. There was a significant reduction in fasting glycemia (43.8%) and HbA1c (22.8%) up to the sixth month (p<0.001). C-peptide did not show any significant alteration until the third month, although there was a considerable increase (25%) between the third and the sixth months (p<0.001). Only two patients were on oral medication after the sixth month.Preliminary results have shown an important effect of the laparoscopic duodenal-jejunal exclusion in the treatment of T2DM. Studies with longer follow-up and a larger number of patients are necessary to better define the role of this new and promising procedure.