45 - World Journal of Gastroenterology

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doi:10.3748/wjg.v17.i45.5021
Key details of the duodenal-jejunal bypass in type 2
diabetes mellitus rats
Li-Ou Han, Li-Hong Zhou, Su-Jun Cheng, Chun Song, Chun-Fang Song
Li-Ou Han, Chun Song, Chun-Fang Song, Department of
General Surgery, Harbin Medical University First Affiliated
Hospital, Harbin 150001, Heilongjiang Province, China
Li-Hong Zhou, Su-Jun Cheng, Department of Endocrinology,
Harbin Medical University First Affiliated Hospital, Harbin
150001, Heilongjiang Province, China
Author contributions: Song CF and Song C designed the research
and contributed equally to this work; Han LO, Zhou LH
and Cheng SJ performed the research; Han LO and Zhou LH
analyzed the data and wrote the paper.
Supported by Scientific Research Fund of Heilongjiang
Provincial Education Department, No. 11541200; and Harbin
Medical University First Affiliated Hospital, No. 2007098
Correspondence to: �r�� �r�� Chun-�ang Chun-�ang Song, Department of
General Surgery, Harbin Medical University First Affiliated
Hospital, 23 Youzheng St, Harbin 150001, Heilongjiang Province,
China. songchunfang3210@126.com
Telephone: +86-451-85555735 Fax: +86-451-85555735
Received: January 12, 2011 Revised: April 26, 2011
Accepted: May 3, 2011
Published online: December 7, 2011
Abstract
AIM: To investigate which surgical techniques and
perioperative regimens yielded the best survival rates
�or diabetic rats undergoing gastric bypass��
METHODS: We per�ormed Roux-en-Y gastric bypass
with reserved gastric volume, a procedure in which
gastrointestinal continuity was reestablished while excluding
the entire duodenum and proximal jejunal loop��
We observed the procedural success rate, long-term
survival, and histopathological sequelae associated with
a number o� technical modi�ications�� These included:
use o� anatomical markers to precisely identi�y Treitz’s
ligament; care�ul dissection along surgical planes; care-
�ul attention to the choice o� regional transection sites;
reconstruction using �ull-thickness anastomoses; use o�
a minimally invasive procedure with prohemostatic pretreatment
and hemorrhage control; prevention o� hypo-
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World J Gastroenterol 2011 December 7; 17(45): 5021-5027
ISSN 1007-9327 (print) ISSN 2219-2840 (online)
© 2011 Baishideng. All rights reserved.
BRIEF ARTICLE
thermic damage; reduction in the length o� the procedure;
and accelerated surgical recovery using �ast-track
surgical modalities such as perioperative permissive
under�eeding and goal-directed volume therapy��
RESULTS: The series of modifications we adopted reduced
operation time �rom 110��02 ± 12��34 min to 78��39
± 7��26 min (P < 0��01), and the procedural success rate
increased �rom 43��3% (13/30) to 90% (18/20) (P < 0��01),
with a long-term survival o� 83��3% (15/18) (P < 0��01)��
CONCLUSION: Using a number o� �ast-track and
damage control surgical techniques, we have success-
�ully established a stable model o� gastric bypass in
diabetic rats��
© 2011 Baishideng�� All rights reserved��
Key words: �uodenal-jejunal bypass; Type 2 diabetes
mellitus; Minimally invasive surgery; Fast-track surgery;
�amage control surgery; Permissive under�eeding;
Goal-directed volume therapy
Peer reviewers: Antonio Basoli, Professor, General Surgery
“Paride Stefanini”, Università di Roma – Sapienza, Viale del
Policlinico 155, Roma 00161, Italy; Dr. İbrahim Sakçak, 6th
Surgery Clinic, Numune Teaching and Education Hospital,
Ankara 061000, Turkey
Han LO, Zhou LH, Cheng SJ, Song C, Song CF. Key details
of the duodenal­jejunal bypass in type 2 diabetes mellitus rats.
World J Gastroenterol 2011; 17(45): 5021-5027 Available
from: URL: http://www.wjgnet.com/1007-9327/full/v17/
i45/5021.htm DOI: http://dx.doi.org/10.3748/wjg.v17.i45.5021
INTRODUCTION
When gastric bypass has been used to treat morbid obesity
in patients with concomitant type 2 diabetes mellitus
5021 December 7, 2011|Volume 17|Issue 45|