Bariatric Times

Sleeve Gastrectomy 2015

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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April 2015 • Supplement A • Bariatric Times A17 5 th INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY threatening morbidities, including minor bleeding, transient d ehydration and/or renal dysfunction, pneumonitis, and gastroesophageal reflux disease (GERD). There was no mortality. The one-year-follow-up rate was 9 2 percent. The average body weight and BMI at one year after LSG-DJB were 66.1±11.2kg and 23.7±2.8kg/m 2 , respectively (p<0.001). The average HbA1c dropped from the baseline value of 8.1 percent (after intensive medical glycemic control prior to surgery) to 6.3 percent (p<0.001). The other glucose metabolism related parameters, including glucose, C- peptide, insulin, homeostatic model assessment insulin resistance (HOMA-IR) and homeostatic model assessment β-cell activity (HOMA- β), were significantly improved as well. Before surgery, 25 out of the 37 patients (68%) were OA users and 23 out of the 37 (62%) were insulin users. At one year after LSG-DJB, these percentages dropped to 21 and 12 percent, respectively (p<0.001). Systolic and diastolic blood pressure, HDL cholesterol, and triglyceride values were also significantly improved. Both total and LDL cholesterol values did not reach statistical significance. Consequently, at one year after LSG-DJB, 13 out of 34 patients (38%) achieved HbA1c less than six percent without diabetic medication, and 19 out of the 34 (56%) achieved HbA1c less than 6.5 percent. Twenty-five out of the 34 patients (74%) achieved optimal glycemic control of HbA1c less than seven percent. The percentage of patients who satisfied the American Diabetes Association (ADA) composite endpoint for the prevention of cardiovascular disease (CVD) events increased from three percent (at baseline) to 24 percent (at 1 year). CONCLUSION Our preliminary results indicate that LSG-DJB is an effective treatment for advanced diabetes associated with mild to moderate obesity in Japanese patients. REFERENCES 1. Kasama K, Tagaya N, Seki Y, et al. Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results. Obes Surg. 2009;19(10):1341–1345. 2. National Health and Nutritional Examination Survey 2013, Japanese Ministry of Health, Labour and Welfare: http://www.mhlw.go.jp/stf/houdou/0 000067890.html Figure 2. The surgery was transmitted live from Tokyo to Montreal. V i e w a c c o m p a n y i n g v i d e o s a t h t t p : / / i c s s g 5 . m e t a b o l i c s u r g e r y. t v Scan here for the direct link

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