Comparison between the Effect of Laparoscopic Sleeve Gastrectomy and Laparoscopic Mini-gastric Bypass on Type 2 Diabetes Mellitus in Obese Patients: A Prospective Study

Abstract

Background: One of the major global health burdens is type 2 diabetes mellitus (T2DM). Laparoscopic sleeve gastrectomy (LSG) has recently been shown to be effective and safe for T2DM management. Laparoscopic mini-gastric bypass (LMGB) was introduced as a simple (one anastomosis) operation combining both restrictive and malabsorptive functions thus suitable for obese patients with metabolic derangements like T2DM. This study aims to compare the effect of LSG and LMGB on T2DM in obese patients. Materials and methods: A cohort study was carried out on obese patients with T2DM submitted for LSG or LMGB in the department of surgery at Suez Canal university hospital and Suez Canal authority hospital, Egypt, from June 2018 to September 2020. The patients were followed up for 12 months. Results: A total of 20 patients were allocated to each group. The change in the mean body mass index (BMI) was significantly higher in the LSG, compared to the LMGB group ( p < 0.05). Both groups exhibited a significant reduction in the HbA1c at the end of follow-up 12 months after surgery; however, the reduction was significantly higher in the LMGB group ( p < 0.05).Among the LSG group, 75 % of the cases showed complete diabetic remission, 15 % showed partial remission, and 10 % showed improvement in their glycemic control at the end of follow-up. Among the LMGB group, 85 % of the cases showed complete diabetic remission and 10 % showed partial remission. The difference between the study groups was statistically significant. Conclusion: The study showed good improvement for T2DM and a great response in losing weight with a significant superiority of LMGB over the LSG.