A 7-year experience with the surgery of biliopancreatic diversion in the modification of Hess-Marceau for the treatment of morbid obesity and type 2 diabetes

Yashkov, Yu I; Nikol'skiy, A V; Бекузаров, Д. К.; Ершова, Е. В.; Огнева, Н А

doi:10.14341/omet2012243-48

Cited by 4 publications

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“…[23]. Максимальное снижение МТ у большинства больных этой группы отмечалось через 2 года после операции и составило 78,1%, частота ранних послеоперационных осложнений -5,7%.…”

Section: шунтирование желудка с гастроеюноанастомозом по руunclassified

“…70 па-циентов из 292 страдали СД2, уровень НbA 1c снизился в среднем с 7,5% (до операции) до 5,6% через 6 месяцев после операции и удерживался на этом уровне на про-тяжении 5 лет. Через 1,5 года после операции отмечена нормализация липидного обмена у всей группы больных (коэффициент атерогенности (КА) <3) [23]. Результаты наших наблюдений и ранее опубликованные данные за-рубежных авторов дали основания считать БПШ наи-более эффективной операцией при СД2 при условии сохраненного функционирующего пула бета-клеток [23].…”

Section: шунтирование желудка с гастроеюноанастомозом по руunclassified

“…К преимуществам операции BPD, помимо стабиль-ного снижения веса и стойкого воздействия на липидный и углеводный обмены, относятся отсутствие выключе-ния желудка из пищеварения, отсутствие инородного тела в верхней части желудка, необходимости допол-нительных манипуляций, как например, регулировки бандажа [23,44]. Кроме того, при BPD-DS и модифи-кации SADI удается сохранить привратник, отсутствует постгастрэктомический синдром (демпинг-синдром), практически не возникают язвы анастомоза [45].…”

Section: шунтирование желудка с гастроеюноанастомозом по руunclassified

“…После операции у больных СД2 наблюдается полная ремиссия или значительное улучшение его тече-ния, а также значительное снижение смертности от свя-занных с СД2 причин [19]. Среди всех бариатрических операций БПШ обладает наиболее выраженным анти-диабетическим эффектом [23,44].…”

Section: влияние на течение сахарного диабетаunclassified

“…Шунтирующие операции в чистом виде были остав-лены из-за высокой частоты осложнений, и в настоя-щее время применяются комбинированные операции, при использовании которых в дополнение к ограниче-нию объема желудка (рестриктивные операции как эле-мент комбинированных операций) ограничивается всасывание питательных веществ за счет шунтирования части тонкой кишки [23,24]. Выбор операции зависит от многих факторов, в первую очередь от ожидаемого эффекта, в т.ч.…”

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Evolution of biliopancreatic diversion in the treatment of morbid obesity and type 2 diabetes mellitus

et al. 2017

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The prevalence of morbid obesity is on the rise. Surgical intervention for the treatment of morbid obesity has been shown to provide high metabolic efficiency, acquiring a special role in the treatment of type 2 diabetes mellitus. Various surgical procedures are used in treating morbid obesity. These include gastric-bypass surgery and biliopancreatic bypass diversion (BPD), each with various advantages of its own. In recent years, BPD (also referred to as the Scopinaro procedure) has evolved and been modified into the single anastomosis duodeno-ileal (SADI) procedure. Like other types of BPD, the SADI procedure effectively reduces excess body weight and promotes normalisation of carbohydrate and lipid metabolism, leading to a reduced frequency of insulin therapy and use of antidiabetic drugs. The potential benefits of the procedure include reduced operative time and a reduced incidence of internal hernias. Studies have also shown that the SADI procedure results in fewer early and late post-operative complications. Given the effectiveness of the procedure, it is necessary to increase the number and duration of observations made to enable further insight into the long-term efficacy and use of the SADI procedure.

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Section: шунтирование желудка с гастроеюноанастомозом по руunclassified

Section: влияние на течение сахарного диабетаunclassified

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Evolution of biliopancreatic diversion in the treatment of morbid obesity and type 2 diabetes mellitus

et al. 2017

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Use of bariatric surgery in patients with type 2 diabetes: help to the practitioner

et al. 2016

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The use of bariatric surgery in patients with obesity and type 2 diabetes mellitus (T2DM) has its own features. In this lecture we discuss indications and contraindications for bariatric surgery, including specific, e.g. presence of type 2 diabetes. Various types of bariatric surgery and the mechanisms of their effects on glucose and lipid metabolism. We show the results of the restrictive and bypass bariatric surgery in patients with obesity and type 2 diabetes, we present requirements for bariatric surgery and parameters of assessment of its effectiveness, including remission of type 2 diabetes after bariatric surgery. The reasons postsurgical hypoglycemia, as well as predictors of effectiveness of bariatric surgery for the metabolic control in patients with obesity and type 2 diabetes.

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Lipid metabolism and production of incretins in patients with obesity and type 2 diabetes mellitus after biliopancreatic diversion in Hess-Marceau modification at the early stages of follow-up

Ершова¹,

Трошина²,

Yashkov³

2016

Obes. metabol.

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Objectives: To study the lipid metabolism and secretion of GLP-1 and GIP in obese patients with type 2 diabetes before and 3 months after biliopancreatic diversion (BPD) in Hess-Marceau modification.Materials and methods: 22 patients (44 [38.0; 55.0] years) with morbid obesity (BMI of 50.1 [41.3; 53.8]) and type 2 diabetes were included in the study. Total cholesterol, LDL-C, HDL-C, TG, GLP-1, GIP were evaluated before and 3 months after BPD.Results: At 3 months after BPD there were decreases in weight by 15.8% and a reduction in total cholesterol levels and LDL-C, an increase in the number of patients with a target value of total cholesterol and LDL-C (from 4/22 (18%) to 20/22 (91%, p = 0.0001)). TG levels during the first 3 months after BPD did not change, but there was a trend to an increase in the number of patients with TG target levels (from 8/22 (32%) to 15/22 (68%, p = 0.058)). Due to the reduction of total cholesterol intake after malabsorbtive surgery, we saw a regular decrease in HDL-cholesterol. 3 months after BPD there was an increase in basal secretion of GLP-1 and GIP as compared to preoperative levels, and a strong positive association of the basal GIP with the HDL-C (r = 0,8, p = 0.007) and a strong negative association – with the atherogenic index (r = – 0,7, p = 0.009) at 3 weeks after surgery.Conclusions: The majority of patients with obesity and type 2 diabetes as early as at 3 months after BPD in the modification by Hess-Marceau achieve a significant improvement in the parameters of lipid metabolism; expect positive impact of the GIP on lipid metabolism.

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A 7-year experience with the surgery of biliopancreatic diversion in the modification of Hess-Marceau for the treatment of morbid obesity and type 2 diabetes

Cited by 4 publications

References 4 publications

Evolution of biliopancreatic diversion in the treatment of morbid obesity and type 2 diabetes mellitus

Evolution of biliopancreatic diversion in the treatment of morbid obesity and type 2 diabetes mellitus

Use of bariatric surgery in patients with type 2 diabetes: help to the practitioner

Lipid metabolism and production of incretins in patients with obesity and type 2 diabetes mellitus after biliopancreatic diversion in Hess-Marceau modification at the early stages of follow-up

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