A Comparative Study Of The Short-term Efficacy Of Sleeve Gastrectomy And Sleeve Gastrectomy Plus Jejunojejunal Bypass In The Treatment Of Obesity And Insulin Resistance

Objective:To compare the short-term clinical efficacy of sleeve gastrectomy versus sleeve gastrectomy plus jejunojejunal bypass in the treatment of obesity and insulin resistance.Method:A retrospective analysis of 60 obese patients with insulin resistance admitted to our hospital from January 2021 to January 2022 were divided into LSG group and LSG+JJB group according to different surgical methods,with 30 people each.Collect and record the clinical data of patients before,during,and after surgery for 1,3,6 and 12 months,including: body weight,waist circumference,BMI,percent excess weight loss(%EWL),fasting blood glucose,fasting insulin,HOMA-IR,blood lipids;Surgery time,intraoperative blood loss,postoperative hospital stay,total hospital cost;Postoperative complications and management.Result:1.A total of 60 patients in both groups successfully completed the operation,and there were no serious complications such as death,bleeding,and gastric leakage after the operation.2.The operation time and total hospitalization cost of LSG+JJB group were more than those in LSG group,and the difference was statistically significant(P<0.05),There were no significant differences in intraoperative blood loss,postoperative exhaust time and postoperative hospital stay(P>0.05).3.The body weight,waist circumference and BMI of the two groups at 1,3,6 and 12 months after surgery were lower than those before surgery,and the differences were statistically significant(P < 0.05).At1,3 and 6 months after surgery,there were no significant differences in body weight,waist circumference,BMI and %EWL between the two groups(P > 0.05).12 months after surgery,the %EWL of LSG+JJB group was higher than that of LSG group,and the BMI of LSG+JJB group was lower than that of LSG group,the difference was statistically significant(P < 0.05).4.FPG,FINS and HOMA-IR of 2 groups at 1,3,6 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P < 0.05).Compared with the same period after surgery,HOMA-IR and FINS levels in LSG+JJB group were lower than those in LSG group,and the difference was statistically significant(P < 0.05).There was no significant difference in FPG and HbA1 c between the two groups during the same period(P > 0.05).5.At 12 months after surgery,12 months after surgery,the remission rate of insulin resistance in LSG+JJB group was 100%,and the difference was statistically significant compared with LSG group(80%)(P < 0.05).6.At 1,3,6 and 12 months after surgery,TC,TG and LDL were lower than before surgery,while HDL was higher than before surgery,the difference was statistically significant(P < 0.05).There was no significant difference between the two groups in the same period(P > 0.05).7.Postoperative complications mainly included nausea,vomiting and hypoproteinemia in the two groups,and there was no statistical significance in the overall incidence between the two groups(P > 0.05).Conclusion:According to the performance one year after surgery,both of the two methods can effectively reduce body weight,relieve insulin resistance and improve glucose and lipid metabolism.Compared with LSG,LSG+JJB is equally safe and does not increase intraoperative blood loss,postoperative exhaust and length of hospital stay.In addition,the weight loss duration of LSG+JJB was longer,the excess weight loss was reduced more,and the insulin resistance was improved more effectively.