Laparoscopic Gastric Diversion Surgery for Diabetes

  Before the Spring Festival, three patients with type II diabetes underwent laparoscopic gastric diversion surgery in our general surgery department and were discharged from the hospital with normal blood sugar after postoperative rehabilitation by the endocrinology department. As far as we know, this is the first time we carry out this type of surgery for type II diabetes.  It is understood that the three patients were previously diagnosed with type II diabetes and had been relying on medication to control their blood glucose for years, but after the “honeymoon period” of medication, their blood glucose fluctuated greatly from time to time.  Professor Yang Hua, director of general surgery, introduced that in the 1950s, foreign doctors found that some obese patients with diabetes had significantly reduced insulin dosage after bariatric surgery, and that the glucose-lowering effect appeared before weight loss. In addition, it was also found that some diabetic patients who underwent major distal gastric resection also experienced a decrease in blood glucose after surgery, which led to clinical attempts to apply this technique to the treatment of type II diabetes. At present, laparoscopic gastric bypass surgery has been widely adopted in Europe and the United States, and most patients stop taking oral medication or insulin therapy before discharge.  Because of the difficulty of wound healing in diabetic patients, the specialists have chosen a laparoscopic technique with a smaller incision to provide better treatment for patients with a minimal window, as opposed to traditional open surgery. During the surgery, experts first made five “keyholes” in the patient’s abdomen, and with the help of laparoscopic skillful operation, the upper and lower ends of the patient’s stomach were cut and separated, leaving only a “small stomach” of about 30 ml, and then the small intestine was cut at the beginning of the jejunum at 100 cm. The small intestine was cut and the distal small intestine was anastomosed with the “small stomach”. Finally, at a distance of 100 cm from the anastomosis, the distal small intestine stump was docked. After nearly 3 hours of effort, the operation was successfully completed.  Three days after the surgery, the three patients were transferred to the Endocrinology Department for further adjustment. When they were discharged one week after the surgery, two of them still had normal blood glucose levels even though they had stopped taking hypoglycemic drugs.  Associate Professor Xu Zhui, director of the Endocrinology Department, also introduced that long-term studies have found that the technique not only reduces blood glucose levels in diabetic patients, but also stops the progression of obesity and impaired glucose tolerance to diabetes, and can reduce the incidence of complications and mortality in diabetic patients.