1. Is the Sleeve Gastrectomy with Jejunal Bypass as good as the Roux-en-Y Gastric Bypass for the treatment of morbid obesity? A comparative study
Matías Sepúlveda, Munir Alamo, Jorge Saba,
Cristián Astorga, Percy Brante, Andrea Sepúlveda

2. We have no conflict of interest
Disclosure
We have no conflict of interest

3. Introduction
Roux-en-Y Gastric Bypass is the gold standard in bariatric surgery
Secondary effects due to duodenal exclusion like ferropenic anemia, low calcium absorption, vitamin deficiencies, dumping, etc.
Sleeve Gastrectomy have not shown results as good as RYGB in terms of weight loss (or diabetes resolution?)
Excess weight loss 57%
Probability of regaining weight 15-75%
Surg Laparosc Endosc Percutan Tech Dec;22(6):479-86

4. Introduction
Year 2004:
Dr. Munir Alamo, in Santiago, Chile, creates a new and more physiological surgical technique, the Sleeve Gastrectomy with Jejunal Bypass
Based on:
A restrictive component
Delivering food to the ileum, known to produce GLP-1 when stimulated
- Alamo et al. Obesity Surgery. 2006, Vol 16, # 3; 353-8
- Alamo et al. Obesity Surgery. 2012, Vol 22, #7;

5. Surgical Technique: Sleeve Gastrectomy with Jejunal Bypass
36 French Boogie
Gastric section 2-3 cm
from pylorous
Section of jejunum 20
cm from Treitz
Jejunum-ileum
anastomosis cm
Due to 4 over 40 cases with anastomotic ulcer we decided to remove the remnant stomach wich was reported in the same year
Alamo M et al. Obesity Surgery 2006, 16; 9:1263-6

7. Surgical Technique: Roux-en-Y Gastric Bypass
36 French Boogie
Gastric pouch of 50 ml
Gastroentero
anastomosis of 25 mm
Alimentary limb of cm
Biliary limb of 100 cm
Due to 4 over 40 cases with anastomotic ulcer we decided to remove the remnant stomach wich was reported in the same year

8. Objective
To compare both surgical techniques (SGYB vs. RYGB) for the treatment of morbid obesity.

9. Patients and Methods
Centro de Cirugía de la Obesidad (CCO) Hospital DIPRECA, Santiago de Chile
Prospective database
Retrospective revision of patients with preoperative BMI >30 kg/m2
Patients operated on from february 2004 to june

10. Design Endpoints Follow-up Excel 2007 Data Base
1. Excess weight loss
2. Improvement of comorbidities
Follow-up
Month 1° - 3° - 6° - 12° yearly thereafter
Phone calls and regular interviews
Excel 2007 Data Base
Statistical analysis STATA 12™
t-test, chi2 y fisher exact test.
p value <0.05.

11. Design Multidisciplinary Team CCO Internists Dietitian Mental Health
Surgeons
All patients received
Polivitaminic p.o.
Vitamin B complex i.m.

12. Results

13. Results

14. %
months
SGJB
330
288
239
176 84 63 35 22
RYGB
133 75 47 54 17 10 8 5

15. Discussion Limitations and Bias: Retrospective
Better follow-up in SGJB
No adressing of complications as dumping, micronutrients levels or anemia
50% of patients undergo SGJB

16. Conclusion
Due to bias towards SGJB, this technique is at least as good as RYGB in terms of excess weight loss and comorbidities resolution. This paper lead us to….

17. … these ongoing prospective trials from March 2012
SGJB vs. RYGB vs. SG in BMI >35
SGJB vs. RYGB in BMI >30 and Diabetes
SGJB vs. SG in BMI >30 and Prediabetes
SGJB vs SG in BMI 30-35