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Role of Laparoscopic Ileal Interposition Associated with Sleeve Gastrectomy in Management of Type 2 Diabetes Mellitus

M.Sc.; Ahmed M.I. Khalil Ahmed E.A. El Kordy, M.D. Mohammed M.M. Omar
The Medical Journal of Cairo University , Volume 88, pp 1641-1647; doi:10.21608/mjcu.2020.116257

Abstract: Background: Type 2 diabetes mellitus has reached pan-demic levels with associated many co-morbidities and decrease in life expectancy. Bariatric surgery presented its value as a definitive solution for type 2 diabetes mellitus management especially with the laparoscopic surgery evolution which occurred since the 1990s. Bariatric surgery has a significant role in remission or alleviation of type 2 diabetes mellitus, weight loss, remission of comorbidities, and the improvement in the quality of life. Aim of Study: We attempt to illustrate, through the available researches, the role of laparoscopic ileal interposition associ-ated with sleeve gastrectomy in management of type 2 diabetes mellitus and the feasibility and efficacy of this procedure as an option in management of type 2 diabetes mellitus and assess the risk to benefit profiles. Material and Methods: The search is carried out using the electronic national library of medicine's PubMed database plus manual reference checks of articles published on lapar-oscopic ileal interposition associated with sleeve gastrectomy in management of type 2 diabetes mellitus in the period between February 2019 to February 2020. The jejuno-ileal interposition associated with sleeve gastrectomy can be an effective method used for management of type 2 diabetes mellitus in patients with BMI less than 35 kg/m2. Results: The results of this procedure are promising regarding its outcome in remission of T2DM and remission of its co-morbidity diseases. The operative time of the proce-dure along with its reasonable post-operative hospital stay and its results in type 2 diabetes mellitus remission may present the procedure as an alternative for other more complex bariatric procedures in management of type 2 diabetes mellitus. Conclusion: The duration time of T2DM, the drug used, the dose of the drug and the BMI of the patient affect the rate of complete remission of T2DM. The procedure can produce adequate control of hyperglycemic state in T2DM patients and satisfactory weight loss without signs of nutritional deficiencies. The procedure seems to be safe and an effective option in the management of type 2 diabetes patients with affordable risk comparing to its long term benefits.
Keywords: diabetes mellitus / evolution / quality of life / Weight loss / bariatric / Remission / Management of Type

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