Sleeve Gastrectomy Versus Single Anastomosis Sleeve Ileal Bypass in The Management of Type II Diabetic Patients with Morbid Obesity

Document Type : Original Article

Authors

1 Departments of General Surgery, Faculty of Medicine, Mansoura University, Egypt

2 Departments of Internal Medicine, Faculty of Medicine, Mansoura University, Egypt

10.21608/ejsur.2025.347110.1324

Abstract

Background: Both laparoscopic sleeve gastrectomy (LSG) and single anastomosis sleeve ileal bypass (SASI) have become
popular bariatric procedures in Egypt. However, their effect on obese diabetic patients is understudied. In the current
study, we compared the previous two metabolic procedures regarding weight loss and improvement of comorbidities in
obese patients with type 2 diabetes mellitus.
Patients and Methods: We enrolled 32 diabetic patients whose BMI was more than 35kg/m2 in this prospective
randomized trial. They were allocated into two groups (16 cases in each): LSG and SASI groups.
Results: All preoperative parameters were comparable between the study groups. Nonetheless, the duration of operation
increased significantly in the SASI group. The excess weight loss percentage showed a significant increase with time, and
it was comparable between the two procedures. Fasting, postprandial plasma glucose, and glycated hemoglobin showed a significant decline in both study groups compared to the baseline, and these follow-up readings were comparable between the two procedures, indicating comparable diabetic outcomes between the two procedures. A positive impact on diabetes (improvement or remission) was noticed in 87.5 and 93.75% of cases in the two groups, respectively, with no statistically significant difference. The improvement of hypertension and dyslipidemia also did not differ between the two groups. No significant nutritional deficiencies were encountered in either group. However, reflux outcomes were better in association with the SASI procedure.
Conclusion: Both LSG and SASI procedures have comparable short-term outcomes regarding weight loss and
improvement of the diabetic state, along with other obesity-related comorbidities.

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