Comparison of five-year physical outcomes in patients undergoing laparoscopic sleeve gastrectomy plus jejunojejunal bypass versus Roux-en-Y gastric bypass.

Abstract

Background: Sleeve gastrectomy plus jejunojejunal bypass (SG + JJB) is increasingly accepted as a surgical treatment for severe obesity. However, data on the long-term results of this procedure are limited, and studies comparing it with other bariatric procedures are scarce.

Objectives: The objective of this study was to compare 5-year outcomes following SG + JJB and Roux-en-Y gastric bypass (RYGB).

Setting: The study was conducted at University Hospital, P.R. China.

Methods: We compared all SG + JJB and RYGB cases handled at our institution between June 2015 and December 2018. We included 329 patients: 167 underwent SG + JJB, and 162 underwent RYGB. All patients completed assessments at presurgery and 5 years after surgery. The data were analyzed using the χ2 test and independent sample t test, with P < .05 denoting statistical significance.

Results: There was no statistically significant difference between the SG + JJB and RYGB groups in terms of weight loss or remission of most associated metabolic complications, such as hypertension, type 2 diabetes mellitus (T2DM), nonalcoholic fatty liver disease (NAFLD), hyperuricemia, and obstructive sleep apnea syndrome (OSAS), although the remission rate of hyperlipidemia was higher in the RYGB group (P < .01). Compared with RYGB, SG + JJB results in lower incidences of dumping syndrome, cholelithiasis, anemia, and gastrointestinal dysfunction (P < .01), and a higher rate of gastroesophageal reflux disease (GERD) (P < .01).

Conclusions: SG + JJB results in sustained weight loss and co-morbidity control after 5 years, yielding a low incidence of adverse events. Like RYGB, SG + JJB seems to be a safe and effective surgical procedure for treating obesity and related diseases.