a-00101 Dr. Robert RUTLEDGETitle of Paper: RESOLUTION OF DIABETES MELLITUS INLOWER WEIGHT PATIENTS WITH MINI-GASTRIC BYPASS Nationality: United States of America Position: Director Department: Surgery Organization: Center For Laparoscopic Obesity Surgery Tel: +1-702 714 0011 E-mail: firstname.lastname@example.org
RESOLUTION OF DIABETESMELLITUS IN LOWER WEIGHTPATIENTS WITH MINI-GASTRIC BYPASS Robert RUTLEDGE11Director, Surgery, Center For Laparoscopic Obesity Surgery, United States of America
Introduction• Bariatric procedures have been shown to improve the outcome of Diabetes Mellitus (DM).
Introduction• The Mini-Gastric Bypass (MGB)• includes both a• Gastric component &• Bypass component• Which has been shown to be more effective than either alone.
Introduction• Studies have shown that the MGB leads to resolution of Type II DM in up to 95% of morbidly obese patients• Because of the risks and danger of DM and the success of the MGB in obese diabetic the MGB was offered to lower weight patients.
Methods:• 6,234 patients underwent MGB including• 303 DM patients with BMI 21-35.• The MGB operations were tailored for lower weight patients• Shorter bypass length and Larger gastric pouch
Tailored MGB?• Think as a General Surgeon NOT as a Bariatric Surgeon• Antrectomy and Billroth II Large pouch and 20-50 cm bypass
Tailored MGB• Antrectomy and Billroth II Large pouch and 20-50 cm bypass• MGB Small Pouch and Long (200 cm) Bypass
Tailored MGB For THIN Diabetic• Antrectomy and Billroth II Large pouch and 20-50 cm bypass• MGB Small Pouch and Long (200 cm) Bypass• Tailored MGB: For THIN Diabetic Pouch << than Antrectomy Pouch >> than “Bariatric” MGB Bypass >> than Antrectomy Bypass << than MGB
Tailored MGB For THIN Diabetic• Antrectomy and Billroth II Minimal Weight Loss• MGB Maximal Weight Loss• Tailored MGB Selected for - Min Weight Loss + Foregut Effect
Results• 68.9% of patients were female.• Average age 48 + 11.• Follow up 6 to 48 months.• Mean preop weight 97 kg and post op was 69 kg• Mean weight loss of 27 kg.
Results• DM resolved in 98% and improved in the remaining patients.• 98% of patients were off all oral medications.• 15.2% were taking insulin and all were taken off the insulin by their physicians.
Conclusions:• The TAILORERD MGB particularly well suited for Rx of DM in low weight patients Gastric pouch = Larger & Bypass length = Shorter Weight loss can be customized• Laparoscopic MGB has a beneficial effect on glucose metabolism and serum lipid composition in obese DM patients.
Conclusions• The Mini-Gastric Bypass improves DM in 95% of obese patients and also leads to resolution or improvement of DM in lower weight patients.