Laparoscopic sleeve gastrectomy with duodenojejunal bypass

Bariatric surgeries can help resolve metabolic derangements concomitant to obesity; therefore, they are now referred to as metabolic surgeries. Duodenojejunal bypass (DJB) is a new procedure of metabolic surgery relying on foregut hypothesis. DJB has been described as standalone procedure to treat non-obese diabetic patients; however, loop DJB may also be performed in combination with sleeve gastrectomy (LDJB/SG) for obese patients. Literature review revealed 59 patients who underwent LDJB/SG in 3 clinical studies. Operation time, complication rate, improvements in preoperative comorbidities, and weight reduction in these patients were assessed. Effect of LDJB/SG on type 2 diabetes was observed to range from 70% to 92.9%, and it improved hypertension by 80% to 85.7% and hyperlipidemia by 100%. Obese patients lost nearly 80% of their excess weight. LDJB/SG is a safe and effective procedure to maintain weight loss in the long term and to achieve perfect outcomes in comorbidity improvement. However, there is a need for long-term follow-up studies.