Short‐Term Operative Outcomes of Loop Reconstruction for Duodenojejunal Bypass With Sleeve Gastrectomy: A Retrospective Study From a Single Japanese Academic Hospital

INTRODUCTION: Roux-en-Y duodenojejunal bypass with sleeve gastrectomy (RY-DJB-SG) generally yields better operative outcomes regarding weight loss and glycemic control compared with SG. However, the requirement of two anastomoses limits its adoption as a primary metabolic bariatric surgery in Japan. To reduce the complexity of RY-DJB-SG, we introduced loop reconstruction for DJB-SG (L-DJB-SG) with a single anastomosis in 2022. This study aimed to assess the feasibility and short-term operative outcomes of L-DJB-SG and RY-DJB-SG. METHODS: Electronic medical records of 13 and 26 patients who underwent L-DJB-SG and RY-DJB-SG, respectively, between May 2012 and November 2023 at our institute were retrospectively analyzed. Patients' demographic characteristics and glycemic and operative outcomes were statistically compared between the two groups. RESULTS: No significant differences in demographic data were observed between the groups. L-DJB-SG exhibited a shorter operation time (221 [206-268] vs. 304 [283-332.3] min, p < 0.01) and required fewer staplers (2 [1.5-2] vs. 5 [3-5], p < 0.01) for bypass procedures compared with RY-DJB-SG, whereas other operative outcomes were comparable. No significant differences in weight loss or glycemic parameters were noted 1 year after surgery. CONCLUSION: L-DJB-SG is a feasible and effective procedure that may serve as an alternative DJB option for Japanese patients with obesity and diabetes mellitus.