Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?

Łukasz Kaska; Jarek Kobiela; Monika Proczko; Tomasz Stefaniak; Zbigniew Śledziński

doi:10.5114/wiitm.2014.40383

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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abstract:

Original paper

Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?

Łukasz Kaska

,

Jarek Kobiela

,

Monika Proczko

,

Tomasz Stefaniak

,

Zbigniew Śledziński

Videosurgery Miniinv 2014; 9 (1): 31–39

DOI: https://doi.org/10.5114/wiitm.2014.40383

Online publish date: 2014/01/30

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AMA

Kaska Ł, Kobiela J, Proczko M, Stefaniak T, Śledziński Z. Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?. Videosurgery and Other Miniinvasive Techniques. 2014:31-39. doi:10.5114/wiitm.2014.40383.

APA

Kaska, Ł., Kobiela, J., Proczko, M., Stefaniak, T.,  & Śledziński, Z. (2014). Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?. Videosurgery and Other Miniinvasive Techniques, 31-39. https://doi.org/10.5114/wiitm.2014.40383

Chicago

Kaska, Łukasz, Jarek Kobiela, Monika Proczko, Tomasz Stefaniak,  and Zbigniew Śledziński. 2014. "Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?". Videosurgery and Other Miniinvasive Techniques: 31-39. doi:10.5114/wiitm.2014.40383.

Harvard

Kaska, Ł., Kobiela, J., Proczko, M., Stefaniak, T.,  and Śledziński, Z. (2014). Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?. Videosurgery and Other Miniinvasive Techniques, pp.31-39. https://doi.org/10.5114/wiitm.2014.40383

MLA

Kaska, Łukasz et al. "Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?." Videosurgery and Other Miniinvasive Techniques, 2014, pp. 31-39. doi:10.5114/wiitm.2014.40383.

Vancouver

Kaska Ł, Kobiela J, Proczko M, Stefaniak T, Śledziński Z. Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?. Videosurgery and Other Miniinvasive Techniques. 2014:31-39. doi:10.5114/wiitm.2014.40383.

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Introduction: The Roux-en-Y gastric bypass (RYGB) is an effective treatment of morbid obesity leading to type 2 diabetes mellitus (T2DM) resolution. However, evidence demonstrates that standard limb lengths can have a limited impact on long-term weight loss and durable T2DM remission.

Aim: The authors evaluated the impact of biliary limb (BL) length on the T2DM laboratory markers in 2-year follow-up.

Material and methods: The data of 93 obese patients with T2DM who underwent RYGB between 2008 and 2010 were collected from prospectively designed database. The length of BL was standard in one group of 51 patients

(S-BL: 50–75 cm) and longer in another group of 42 patients (L-BL: 100–150 cm). The laboratory parameters defining T2DM remission – fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) – were measured 3, 6, 12 and 24 months after surgery.

Results: The average level of FPG and HbA1c remained non-diabetic 24 months after the RYGB in both groups. A statistical difference was not observed in direct FPG, HbA1c, FPG and HbA1c comparisons at any follow-up point. However, a significantly higher proportion of patients in L-BL than in S-BL reached the laboratory remission criteria without anti-diabetic medicaments. Additional analysis revealed a strong correlation between the measured T2DM parameters and length of the common limb (CL) in both groups.

Conclusions: A longer BL can intensify the anti-diabetic effect of RYGB. The length of CL rather than BL influences the medium-term T2DM remission. Long-term observation is needed to fully assess whether introduced technical aspects of RYGB provide a durable effect of T2DM resolution.

keywords:

Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients?

Łukasz Kaska , Jarek Kobiela , Monika Proczko , Tomasz Stefaniak , Zbigniew Śledziński

type 2 diabetes mellitus, Roux-en-Y gastric bypass, biliary limb, laboratory remission

Łukasz Kaska

,

Jarek Kobiela

,

Monika Proczko

,

Tomasz Stefaniak

,

Zbigniew Śledziński