Novel Metabolic/Bariatric Surgery — Loop Duodenojejunostomy with Sleeve Gastrectomy (LDJB-SG)

Bariatric and Metabolic Surgery

“…The drop in HbA1C was also lower in the LDJB-SG compared to the RYGB (6.0 ± 0.9 vs 6.3 ± 1.2) although this did not attain a statistically significant level (P value = 0.442). Resolution of other obesity-related comorbid factors were also seen in LDJB-SG that was comparable to the RYGB group (Hypertension = 85.7% vs 88.2% and Dyslipidemia = 70% vs 76.6% resolution rates) [8].…”

“…This can also be offered as a surgical treatment for poorly controlled type 2 diabetes in Asian patients with BMI ≥ 32.5 kg/m 2 without comorbidities or >27.5 kg/m 2 with comorbidities. Contraindications include chronic alcoholism, drug and substance abuse, major psychiatric disorder, severe gastroesophageal reflux disease and chronic duodenal ulcer [8].…”

“…Using a 45 mm curved tip articulating tan reload (EGIA45CTAVM Endo GIA 45 mm Curved Tip articulating vascular/medium reload with Tri-Staple™ Technology), the first part of the duodenum is transected. Care is taken to avoid injury to the common bile duct (CBD), pancreas and major vessels in the area (Figure 20) [8]. …”

“…A completely hand-sewn side to side duodenojejunal anastomosis in a running fashion is created using a 3-0 absorbable glyconate monofilament suture (3-0 B | BRAUN MONOSYN™ UNDYED 28" HR26 TAPER) (Figures 23-25). Then an antitorsion suture between antrum and jejunum is placed, around 4 cm proximal to the D-J anastomosis [8]. …”

Bariatric and Metabolic Surgery

“…Contraindications include chronic alcoholism, drug and substance abuse, major psychiatric disorder, severe gastroesophageal reflux disease and chronic duodenal ulcer [8].…”