Comparative clinical study of the effects of gastric bypass with different types of anastomosis on type 2 diabetes mellitus        WANG Lie, ZHANG Zai-zhong, HUANG Sheng, et al. Research Institute of General Surgery, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China
Corresponding author: WANG Yu, E-mail:fzptwk@163.com
Abstract    Objective    To assess the effects of gastric bypass with different types of anastomosis on type 2 diabetes mellitus (T2DM). Methods    From June 2006 to February 2009, 61 patients with gastric lesions combined with type 2 diabetes mellitus performed gastrectomy were prospectively assigned into Billroth Ⅰ group (n=11), Billroth Ⅱ group (n=26) and Roux-en-Y group (n=24) in Fuzhou General Hospital of Nanjing Military Command. The pre- and postoperative clinical parameters associated with glycometabolism and body mass index were measured during a 6-month follow-up period. Results    Fasting blood glucose and glycated hemoglobin levels were significantly decreased after surgery in both Billroth Ⅱ and Roux-en-Y groups (P<0.01 or P<0.05). At 3 and 6 months, patients in both BillrothⅡ and Roux-en-Y groups had significantly increased fasting C-peptide and significant improved oral glucose tolerance test (P<0.01 or P<0.05). The changes of those parameters above in Roux-en-Y group were greater than those in Billroth Ⅱ group(P<0.01 or P<0.05). However, the effects were not shown in Billroth Ⅰ group through the entire follow-up period. T2DM control rate in Roux-en-Y group was higher than that in Billroth Ⅰ and Billroth Ⅱ group (P<0.01 or P<0.05). Conclusion    As compared with Billroth Ⅰ and Billroth Ⅱ reconstruction after gastrectomy, Roux-en-Y gastric bypass seems to be more effective on T2DM control. The therapeutic effect of gastric bypass is independent on loss of body weight. Roux-en-Y gastric bypass may be as a potential management option for T2DM.