2ND WORLD CONGRESS ON INTERVENTIONAL THERAPIES FOR TYPE 2 DIABETES. New York. 28-30 de marzo de 2011.
La primera referencia del bypass gastroileal en el tratamiento de la diabetes tipo 2 tuvo lugar en el 2º Congreso Mundial de Terapias Instrumentales de la Diabetes tipo 2 en New York (2011). En el primer congreso, celebrado el año 2008, habíamos participado en una estadística mundial conjunta aportando nuestra experiencia con el bypass biliopancreáticos metabólicos sin gastrectomía.
Este texto apareció en el libro de resúmenes de presentaciones.
En este momento, la experiencia era muy pequeña en número de pacientes; pero muy importante por lo reciente que era la cirugía metabólica y lo pionera que era la técnica.
Laparoscopic gastroileal bypass for diabetes treatment in nonmorbidly obese patients.
Resa JJ, Lagos J, Valero M.
Department of Metabolic and Bariatric Laparoscopic Surgery , Montpellier Clinic, Zaragoza, Spain.
BACKGROUND: Since 2000 year we have perfored more than 500 laparoscopic biliopancreatic diversion without gastrectomy (LBPD-G) for morbid obesity treatment with excellent results. In 2008 year we began to treat diabetes in nonmorbidly obese patients through LBPD-G with 200 cm alimentary limb plus 200 cm common limb with 92% of diabetes resolution. To simplify the technic and aboid steatorrhoea we developed the laparoscopic gastrileal bypass, an operation between biliopancreatic diversion and minigastric bypass.
METHODS: Prospective study on oral glucose loads in 20 severe diabetic patients (body mass index [BMI] >30 and <35, HbA1C >7.5%) before and at 1, 3, 6, 12, 18 and 24 months after laparoscopic gastroileal bypass with a horizontal gastric trasection and 300 cm gastroenteral anastomosis from ileocecal valve.
RESULTS: Of the 20 patients enrolled, the mean age was 46.7 years, mean BMI was 33.45, mean fasting plasma glucose was 181.8 and mean HbA1C was 8.9. The mean BMI at 1, 3, 6, 12, 18 and 24 months after operation were 30.79, 28.48, 27.44, 26.54, 25.82 and 25.68, respectively. The mean HbA1C at 1, 3, 6, 12, 18 and 24 months after operation were 7.3, 5.86, 5.9, 5.5, 5.7 and 5.6, respectively. Resolution of type 2 diabetes was achieved in 15 (75%) patients at 3 months and 20 (100%) at 12 months after gastroileal bypass. The mean operating time was 30 minutes, without complications and mortality. Single port laparoscopic was accomplished in 5 patients.
CONCLUSION: Laparosopic gastroileal bypass seems to be a promising procedure for the control of T2DM and the metabolic syndrome.
