The Clinical Study Of The Modified Laparoscopic Roux-en-Y Gastric Bypass On Type 2 Diabetes Mellitus

Objective:15 cases of non-obese (BMI<35kg/m2) T2DM patients were treated by modified laparoscopic Roux-en-Y gastric bypass. Clinical efficacy and safety of modified laparoscopic Roux-en-Y gastric bypass surgery was evaluated on Chinese non-obese T2DM patients.Methods:15 patients with T2DM were slected based on the inclusion and exclusion criteria into the group, all the patients were underwent modified laparoscopic Roux-en-Y gastric bypass surgery. The clinic parameters such as glycated hemoglobin, fasting plasma glucose,2-hour postprandial blood glucose, oral glucose tolerance, C peptide and insulin release test, BMI, hemoglobin, plasma albumin were evaluated in pre-operation and post-operation and the incidence of operative complications was recorded. The clinic parameters between pre-operation and post-operation were compared.Results:(1) The results demonstrated postoperative hemoglobin (6.71±0.72%) decreased significantly (p<0.05), the value of OGTT, CPRT and IRT in different time points were significantly ameliorated (P<0.05) after the operation for 3 months. It indicated postoperative patients'glucose metabolism and function of pancreatic islet improved after surgery.(2) The preoperative value of clinic parameters demonstrated fasting blood glucose was (8.63±2.24mmol/L),2h-postprandial blood glucose was (16.85±3.79mmol/L), hemoglobin was (8.21±1.85%). The postoperative results demonstrated fasting blood glucose (5.76±2.46mmol/L) significantly decreased (p<0.05),2-hour postprandial blood glucose (11.56±2.20mmol/L) and hemoglobin (6.61±0.81%) also significantly decreased after operation for 6 months. It indicated the postoperative patients'glucose metabolism still significantly improved after operation for 6 months.(3)After operation for 3 months, there were no significant changes(p>0.05) in postoperative blood hemoglobin (133±16.82g/L) and serum albumin (41.85±3.76g/L) compared with preoperative hemoglobin (139.58±13.88g/L) and serum albumin (40.58±3.77g/L). Postoperative BMI(26.46±2.88 kg/m2) also didn't changes(p>0.05) compared with preoperative BMI(26.83±3.05 kg/m2).(4)There were no death cases.1 case of gastroparesis and gastric retention,3 cases of anastomotic ulcer,1 case of adhesive intestinal obstruction were observed in 15 patients after operation.Conclusions:(1) The modified laparoscopic Roux-en-Y gastric bypass surgery was a effective and potential treatment of non-obese T2DM.(2) The modified laparoscopic Roux-en-Y gastric bypass surgery had little influence on nutrition absorption and intake to postoperative patients with T2DM.(3) The modified laparoscopic Roux-en-Y gastric bypass surgery was possessed of higher security to T2DM patients.