SLEEVE GASTRECTOMY WITH DUODENO-ILEAL INTERPOSITION:
Metabolic surgery results in resolution or long term remission of Type 2 Diabetes (T2D), due to several hormonal changes such as reduced Ghrelin, increased GLP1 and Peptide YY. Bilio-pancreatic Diversion with Duodenal Switch (BPD-DS) is the most effective metabolic surgery since hormonal changes are maximum. But significant malabsorption can be a problem. Sleeve gastrectomy with duodeno-ileal interposition (SG-DII), a modification of BPD-DS, is equally effective but with significantly less malabsorption. Addition of one extra anastomosis (Ileo-jejunal anastomosis) to BPD-DS, greatly reduces malabsorption without affecting hormonal changes necessary for T2D resolution or weight loss. This makes SG-DII one of the most effective metabolic surgery to treat T2D even in normal weight patients with uncontrolled T2D. SG-DII = BPD-DS + Ileo-jejunal Anastomosis.
For information on obesity and diabetes surgery
Dr. Amar Bariatric and Metabolic Institute, Hyderabad, India.
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