Comparing Hormonal Changes and Blood Sugar Effects of Sleeve Gastrectomy with Duodenojejunal Bypass Versus Roux-en-Y Gastric Bypass in Adults with Severe Obesity

What this Trial Is About

Researchers are comparing two bariatric surgery techniques in people with super morbid obesity, specifically those with a BMI of 50-60 kgm2 who have not lost weight despite medical therapy and exercise. The study evaluates hormonal responses and the incidence of post-bariatric hypoglycemia after laparoscopic Roux-en-Y gastric bypass LRYGB and laparoscopic sleeve gastrectomy with duodenojejunal bypass LSG-DJB. This comparison aims to clarify the mechanisms behind weight loss and postprandial blood sugar changes following these surgeries. The study involves two surgical procedures. LSG-DJB reduces stomach volume to about 80-150 mL and reroutes part of the small intestine to create a bypass, while LRYGB reduces stomach volume to about 15-50 mL and connects the jejunum directly to the gastric pouch with a different bypass configuration. Participants are randomly assigned to receive one of the two procedures, with LRYGB being the standard approach and LSG-DJB as the experimental technique. Participants will be followed for 6 to 24 months after surgery, during which researchers will assess hormonal responses including GLP-1, GIP, glucagon, and insulin levels. They will also monitor the occurrence of post-bariatric hypoglycemia and other outcomes related to weight loss and metabolic health. This extended monitoring helps understand the benefits and risks of each surgery over time.

Comparison of Hormonal Response to a Mixed-Meal Tolerance Test After Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy With Duodenojejunal Bypass in Patients With Super Morbid Obesity