Comparative Study Between Sleeve Gastrectomy With Single Anastomosis Duodeno-Ileal Bypass and Mini-Gastric Bypass in Management of Morbid Obesity.

Abstract

Background: Many surgical procedures have been proposed for management of morbid obesity. This study was conducted aiming to compare between the outcomes of open loop duodenal switch (DS) and laparoscopic minigastric bypass (MGB) procedures. Study type: Prospective comparative study. Patient and methods: 50 patients were included in the study. They were divided into 2 groups; group 1 included 25 patients who underwent open loop DS while group 2 included 25 patients who underwent laparoscopic minigastric bypass. All patients were subjected to complete history taking, physical examination, and routine investigations. Lipid profile and diabetic status were also assessed. After discharge, patients were followed up at 3, 6, and 12 months after the procedures where weight, BMI, and laboratory investigations were assessed in each visit. Results: The mean age of the included patients was 34.76 for the DS group and 36.0 years for MGB group. In each group, 20 females (80%) as well as 5 males (20%) were included. The mean BMI of the included patients was 52.59 and 51.6 kg/m 2 for both groups respectively. No significant difference was detected between the two groups regarding preoperative albumin, lipid profile, or HbA1c levels. Mean patient weight decreased postoperatively to 128.92, 117.63, and 105.28 kg after 3, 6, and 12 months in DS group. In the MGB group, mean weight decreased to 133.75, 124.14, 117.16 kg at the same time intervals respectively. BMI decreased to 48.45, 43.01, and 38.27 kg/m 2 in DS group while in the other group it showed a decrease down to 49.35, 46.89, and 42.33 kg/m 2 at the previously reported time intervals in order of speech. It was evident that 6-and 12-month changes were significantly better in Ds group compared to MGB group (p < 0.05). Conclusion: Based on the results of the current study, it was evident that both open loop duodenal switch and laparoscopic minigastric bypass procedures are effective in the management of morbid obesity and its related comorbidities. However, loop DS operation is more effective in weight loss compared to MGB.