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Objective <p>To report the 10-year outcomes of laparoscopic sleeve gastrectomy with Roux-en-Y duodenojejunal bypass (LSG-DJB) on weight loss, resolution of associated medical problems, and nutritional status.</p> Background <p>LSG-DJB is an established metabolic procedure as an alternative to laparoscopic Roux-en-Y gastric bypass (LRYGB), especially in Asia, where the incidence of gastric cancer is relatively high, but long-term data are limited.</p> Methods <p>A retrospective study conducted at a single center involving 177 patients who underwent LSG-DJB, with follow-up data available for up to 10 years. Outcomes measured included weight loss, remission rates of T2DM, hypertension, dyslipidemia, and nutritional markers.</p> Results <p>Durable weight loss was maintained over 8–10 years, with %TWL of 28.9% and %EWL of 93.1%. The remission rates at 8–10 years were 35.5% for T2DM, 39.1% for hypertension, and 48.1% for dyslipidemia. Liver enzyme and uric acid levels also showed significant, sustained improvements. The rate of conversion surgery was low (4%), with no cases of severe malnutrition. The prevalence of anemia increased to 25%, although the mean hemoglobin and iron levels remained stable.</p> Conclusions <p>This is the first report on the long-term outcomes of LSG-DJB. It shows sustained weight loss and control of associated medical problems at 8–10 years, aligning with published data on RYGB. It effectively prevents severe malnutrition but requires monitoring for anemia. These findings confirm the long-term effectiveness and nutritional safety of LSG-DJB and provide strong support for future RCTs that directly compare it to other procedures over more extended follow-up periods.</p>

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Ten-Year Outcomes of Laparoscopic Sleeve Gastrectomy with Roux-en-Y Duodenojejunal Bypass on Weight Loss, Metabolic Syndrome, and Nutrition: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年11月27日

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  • Ralph Victor Yap,
  • Yosuke Seki,
  • Kazunori Kasama,
  • Eri Kikkawa,
  • Ai Takezawa,
  • Renzo Yokoyama

摘要

Objective

To report the 10-year outcomes of laparoscopic sleeve gastrectomy with Roux-en-Y duodenojejunal bypass (LSG-DJB) on weight loss, resolution of associated medical problems, and nutritional status.

Background

LSG-DJB is an established metabolic procedure as an alternative to laparoscopic Roux-en-Y gastric bypass (LRYGB), especially in Asia, where the incidence of gastric cancer is relatively high, but long-term data are limited.

Methods

A retrospective study conducted at a single center involving 177 patients who underwent LSG-DJB, with follow-up data available for up to 10 years. Outcomes measured included weight loss, remission rates of T2DM, hypertension, dyslipidemia, and nutritional markers.

Results

Durable weight loss was maintained over 8–10 years, with %TWL of 28.9% and %EWL of 93.1%. The remission rates at 8–10 years were 35.5% for T2DM, 39.1% for hypertension, and 48.1% for dyslipidemia. Liver enzyme and uric acid levels also showed significant, sustained improvements. The rate of conversion surgery was low (4%), with no cases of severe malnutrition. The prevalence of anemia increased to 25%, although the mean hemoglobin and iron levels remained stable.

Conclusions

This is the first report on the long-term outcomes of LSG-DJB. It shows sustained weight loss and control of associated medical problems at 8–10 years, aligning with published data on RYGB. It effectively prevents severe malnutrition but requires monitoring for anemia. These findings confirm the long-term effectiveness and nutritional safety of LSG-DJB and provide strong support for future RCTs that directly compare it to other procedures over more extended follow-up periods.