Longitudinal Outcomes Through 4 Years After Sleeve Gastrectomy with Transit Bipartition

Abstract

Background: Sleeve gastrectomy with transit bipartition (SG-TB) is a newer sleeve gastrectomy (SG) modification that has been reported almost exclusively over the short term. This study evaluated post SG-TB changes in weight, type 2 diabetes (T2D), and nutritional parameters through 48 months.Methods: In a single-center retrospective analysis, patients with obesity and T2D underwent SG-TB. Primary outcomes were as follows: body mass index (BMI), excess BMI loss (EBMIL), total weight loss (TWL), and glycosylated hemoglobin (A1C). Mean and median changes were assessed at 6, 12, 24, 36, and 48 months using parametric and nonparametric repeated-measures analysis of variance.Results: Between 2015 and 2019, 669 patients (mean BMI 35.7 +/- 4.6 kg/m(2) [30.0-57.8]) underwent SG-TB (mean age 52.2 +/- 9.2 years, T2D duration 12.6 +/- 6.2 years, A1C 9.7% +/- 1.5%). At 48 months, 44 patients were available for analysis: Mean EBMIL was 79.4% +/- 25.0% (95% confidence interval 71.8-87.0), and TWL 21.0% +/- 5.9% (19.2-22.8), corresponding to a mean BMI change of 7.5 +/- 2.8 kg/m(2) (6.6-8.4) (p < 0.001). Complete T2D remission was achieved by 38/44 (86.4%). Significant increases occurred in the proportion of patients in the normal nutritional reference ranges. Overall complications were 10.2% with no mortality.Conclusion: Over 48 months, patients with obesity and T2D who underwent SG-TB experienced durable weight loss, T2D resolution, and nutritional stability.