R.C. Luiciani
Groupement Hospitalier Les Portes du Sud, France
Title: Duodenal Diversion and Surgical Treatment of Type 2 Diabetes in Midly Obese Patients: What Metabolic Surgery has to Learn from General Surgery
Biography
Biography: R.C. Luiciani
Abstract
Many recent prospective studies have undoubtedly proven metabolic surgery to be the most effective treatment of T2DM compared with medical management. Therefore bariatric surgeons have now to question the best surgical procedure to achieve diabetes improvement or even resolution not only in severely obese patients but also in mildly obese ones without exposing them to the risk of malnutrition. To achieve this goal, metabolic surgery can surely benefit from the previous results of general surgery in regards to the very different effects of the various types of reconstruction after gastrectomy (Billroth I versus Billroth II and Roux en Y) both in diabetic and nondiabetic patients. This presentation reviews the results of general and oncological gastric surgery and their implications in the field of diabetology. According to these data duodenal diversion reconstruction after gastrectomy significantly improves T2DM in diabetic patients while it seems on the opposite to worthen glucose metabolism in non-diabetic ones. These conclusions should lead to excluding restrictive procedures without duodenal diversion in the surgical management of T2DM avoiding much malabsorption and weight loss in thin diabetic patients