Gastroenterologie
a hepatologie

Partial jejunal diversion – technical aspects and preliminary experience

Pavol Holéczy ^{Orcid.org  1,2}, Marek Bužga ^{Orcid.org  3}, Jitka Macháčková⁴, Martin Bolek⁵

+ Affiliation
¹ Katedra chirurgických oborů, LF OU v Ostravě
² Chirurgické oddělení, Vítkovická nemocnice a. s., Ostrava
³ Ústav fyziologie a patofyziologie, LF OU v Ostravě
⁴ Katedra fyziologie a patofyziologie, LF OU v Ostravě
⁵ Chirurgické oddělení, Vítkovická nemocnice, a. s., Ostrava

Summary

Introduction: Bariatric/metabolic surgery is a well-established way of treating severe obesity and comorbidities associated with it. There are also new types of procedures that focus on comorbidity treatment rather than weight reduction. Less invasive interventions are the preferred option. The aim of this study is to present the short-term results of a new surgical method – partial jejunal diversion (PJD) – and to describe its technical aspects. Material and methods: This is a prospective study in which 14 patients were operated on from September 2016 to February 2018. There were 8 women and 6 men in the studied group, whose average age was 47.3 years. Their BMI varied from 32.89 to 47.6 kg/sqm, and the average value was 43.5 kg/sqm. Diabetes mellitus type 2 was observed in 4 patients. Eight patients were evaluated after 12 months of follow-up. For the purpose of this study, we chose to evaluate weight changes, BMI changes, and changes in glycid metabolism. We also evaluated the incidence of complications. Results: The operation time ranged from 27 to 61 minutes, and no preoperative complications were recorded. Two (14.28%) patients had to be re-operated on for inner hernia in the follow-up period. The average weight loss was from 122.6 to 102.9 kg, i.e. BMI from 43.5 to 36.3 kg/sqm. Glycated haemoglobin decreased from 41.5 mmol/mol to 34.4 mmol/mol. All changes were statistically significant. Changes in fasting blood glucose were not statistically significant. Discussion: The long-term results of standard metabolic operations are well known. In order to minimize the invasivity new operations are sought; PJD is one of these. It is expected that PJD will have a metabolic effect, especially in type 2 diabetes, as has been suggested by the published results. Conclusion: Our results confirm that there has been significant weight reduction and improved glycide metabolism. It is clear that it will be necessary to evaluate the effect of the operation in the long term and in a larger cohort. The short-term results allow us to assume a positive effect, especially in type 2  diabetics.

Keywords

type 2 diabetes mellitus, jejunal diversion, metabolic surgery, obesity

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