Prospects and considerations of sleeve gastrectomy with transit bipartition_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAO Libin , WANG Jian ,  ZHU Xiaocheng

Department of Gastrointestinal Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P. R. China;

Corresponding author：

ZHU Xiaocheng, Email: zhuxccf@163.com

Keywords：

obesity; type 2 diabetes mellitus; metabolic and bariatric surgery; sleeve gastrectomy; transit bipartition

DOI：

10.7507/1007-9424.202310025

Video：

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Sleeve gastrectomy with transit bipartition (SG-TB) was a novel bariatric and metabolic surgery that had received preliminary approval for its effectiveness and safety in reducing weight, improving diabetes, and other metabolic diseases. It showed promising prospects in clinical applications. However, SG-TB also faced some challenges including a small number of cases, insufficient clinical evidence, issues with anastomotic stoma and common channel design, bile reflux, gastroesophageal reflux disease, and malnutrition. Further research is needed to enhance the standardization of SG-TB procedures and provides reference for its wider implementation.

Citation： YAO Libin, WANG Jian, ZHU Xiaocheng. Prospects and considerations of sleeve gastrectomy with transit bipartition. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 398-402. doi: 10.7507/1007-9424.202310025 Copy

1.	郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
2.	朱利勇, 李伟正, 朱晒红. 减重手术术式选择. 中国普外基础与临床杂志, 2019, 26(6): 645-648.
3.	Santoro S, Malzoni CE, Velhote MC, et al. Digestive adaptation with intestinal reserve: a neuroendocrine-based operation for morbid obesity. Obes Surg, 2006, 16(10): 1371-1379.
4.	Mui WL, Lee DW, Lam KK. Laparoscopic sleeve gastrectomy with loop bipartition: a novel metabolic operation in treating obese type Ⅱ diabetes mellitus. Int J Surg Case Rep, 2014, 5(2): 56-58.
5.	Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg, 2016, 34: 28-34.
6.	Widjaja J, Sun X, Chu Y, et al. Sleeve gastrectomy with Braun anastomosis transit bipartition (B-TB): a potential midway between single anastomosis and Roux-en-Y transit bipartition. Obes Surg, 2021, 31(12): 5500-5503.
7.	Zhu X, Widjaja J, Yao L, et al. A new minimal-injury technique to demarcate the small intestine. Obes Surg, 2022, 32(6): 2087-2089.
8.	Calisir A, Ece I, Yilmaz H, et al. The mid-term effects of transit bipartition with sleeve gastrectomy on glycemic control, weight loss, and nutritional status in patients with type 2 diabetes mellitus: a retrospective analysis of a 3-year follow-up. Obes Surg, 2021, 31(11): 4724-4733.
9.	杜靖, 刘丹丹, 刘秀, 等. 肠道菌群在减重手术后的变化及改善代谢的机制. 中国普外基础与临床杂志, 2023, 30(3): 279-284.
10.	Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
11.	Al M, Taskin HE. Weight loss, type 2 diabetes, and nutrition in 355 patients with obesity undergoing sleeve gastrectomy with transit bipartition: two-year outcomes. Obes Facts, 2022, 15(5): 717-729.
12.	Emile SH, Mahdy T, Schou C, et al. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg, 2021, 92: 106024. doi: 10.1016/j.ijsu.2021.106024.
13.	Emile SH, Elfeki H, Elalfy K, et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech, 2017, 27(5): 307-317.
14.	Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12 807 patients. Obes Surg, 2018, 28(9): 2956-2967.
15.	Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med, 2012, 366(17): 1567-1576.
16.	Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg, 2021, 31(4): 1579-1589.
17.	Topart P, Becouarn G, Finel JB. Comparison of 2-year results of Roux-en-Y gastric bypass and transit bipartition with sleeve gastrectomy for superobesity. Obes Surg, 2020, 30(9): 3402-3407.
18.	Topart P, Becouarn G, Finel JB. Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures. Surg Obes Relat Dis, 2020, 16(4): 497-502.
19.	姚立彬, 邵永, 洪健, 等. 腹腔镜胃袖状切除联合双通路手术41例短期疗效分析. 中国实用外科杂志, 2021, 41(9): 1024-1028.
20.	Liu P, Widjaja J, Dolo PR, et al. Comparing the anti-diabetic effect of sleeve gastrectomy with transit bipartition against sleeve gastrectomy and Roux-en-Y gastric bypass using a diabetic rodent model. Obes Surg, 2021, 31(5): 2203-2210.
21.	Hosseini SV, Moeinvaziri N, Medhati P, et al. The effect of single-anastomosis sleeve ileal (SASI) bypass on patients with severe obesity in three consecutive years. World J Surg, 2022, 46(11): 2744-2750.
22.	Emile SH, Madyan A, Mahdy T, et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc, 2021, 35(2): 652-660.
23.	Hosseini SV, Moeinvaziri N, Medhati P, et al. Optimal length of biliopancreatic limb in single anastomosis sleeve gastrointestinal bypass for treatment of severe obesity: efficacy and concerns. Obes Surg, 2022, 32(8): 2582-2590.
24.	Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg, 2020, 30(4): 1437-1445.
25.	Taskin HE, Al M. Testosterone changes in men with obesity and type 2 diabetes 6 months after sleeve gastrectomy with transit bipartition. Surg Laparosc Endosc Percutan Tech, 2022, 32(2): 188-196.
26.	舒畅, 姚立彬, 洪健, 等. 3种不同减重手术方式治疗肥胖合并糖尿病肾病大鼠的疗效差异对比分析. 中国普外基础与临床杂志, 2023, 30(9): 1063-1072.
27.	Al M, Taskin HE. Sleeve gastrectomy with transit bipartition in a series of 883 patients with mild obesity: early effectiveness and safety outcomes. Surg Endosc, 2022, 36(4): 2631-2642.
28.	Mahdy T, Emile SH, Madyan A, et al. Evaluation of the efficacy of single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: a multicenter study. Obes Surg, 2020, 30(3): 837-845.
29.	Salama TMS, Sabry K, Ghamrini YE. Single anastomosis sleeve ileal bypass: new step in the evolution of bariatric surgeries. J Invest Surg, 2017, 30(5): 291-296.
30.	Kermansaravi M, Kabir A, Pazouki A. 1-year follow-up of single anastomosis sleeve ileal (SASI) bypass in morbid obese patients: efficacy and concerns. Obes Surg, 2020, 30(11): 4286-4292.
31.	Bhandari M, Fobi MAL, Buchwald JN, et al. Standardization of bariatric metabolic procedures: world consensus meeting statement. Obes Surg, 2019, 29(Suppl 4): 309-345.
32.	Emile SH, Mahdy T. Excessive weight loss and hypoalbuminemia after SASI bypass: the need for standardization of the technique. Obes Surg, 2021, 31(2): 865-866.
33.	Hosseini SV, Haghighat N, Kamran H, et al. Braun anastomosis: a technique for bile reflux improvement after single anastomosis sleeve ileal (SASI) bypass; a pilot study. Surg Innov, 2023, 30(3): 297-302.
34.	Rezaei MT, Sheikhbahaei E, Zefreh H, et al. Single-anastomosis sleeve jejunal: a mid-term follow-up report of a new surgical technique. Obes Surg, 2023, 33(4): 1245-1252.
35.	Wang M, Widjaja J, Dolo PR, et al. The protective effect of transit bipartition and its modification against sleeve gastrectomy-related esophagitis in a rodent model. Obes Surg, 2022, 32(4): 1149-1156.
36.	朱孝成, 姚立彬. 胃袖状切除术联合双通道术的价值与存在问题. 中国实用外科杂志, 2023, 43(5): 523-528.

1. 郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
2. 朱利勇, 李伟正, 朱晒红. 减重手术术式选择. 中国普外基础与临床杂志, 2019, 26(6): 645-648.
3. Santoro S, Malzoni CE, Velhote MC, et al. Digestive adaptation with intestinal reserve: a neuroendocrine-based operation for morbid obesity. Obes Surg, 2006, 16(10): 1371-1379.
4. Mui WL, Lee DW, Lam KK. Laparoscopic sleeve gastrectomy with loop bipartition: a novel metabolic operation in treating obese type Ⅱ diabetes mellitus. Int J Surg Case Rep, 2014, 5(2): 56-58.
5. Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg, 2016, 34: 28-34.
6. Widjaja J, Sun X, Chu Y, et al. Sleeve gastrectomy with Braun anastomosis transit bipartition (B-TB): a potential midway between single anastomosis and Roux-en-Y transit bipartition. Obes Surg, 2021, 31(12): 5500-5503.
7. Zhu X, Widjaja J, Yao L, et al. A new minimal-injury technique to demarcate the small intestine. Obes Surg, 2022, 32(6): 2087-2089.
8. Calisir A, Ece I, Yilmaz H, et al. The mid-term effects of transit bipartition with sleeve gastrectomy on glycemic control, weight loss, and nutritional status in patients with type 2 diabetes mellitus: a retrospective analysis of a 3-year follow-up. Obes Surg, 2021, 31(11): 4724-4733.
9. 杜靖, 刘丹丹, 刘秀, 等. 肠道菌群在减重手术后的变化及改善代谢的机制. 中国普外基础与临床杂志, 2023, 30(3): 279-284.
10. Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
11. Al M, Taskin HE. Weight loss, type 2 diabetes, and nutrition in 355 patients with obesity undergoing sleeve gastrectomy with transit bipartition: two-year outcomes. Obes Facts, 2022, 15(5): 717-729.
12. Emile SH, Mahdy T, Schou C, et al. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg, 2021, 92: 106024. doi: 10.1016/j.ijsu.2021.106024.
13. Emile SH, Elfeki H, Elalfy K, et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech, 2017, 27(5): 307-317.
14. Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12 807 patients. Obes Surg, 2018, 28(9): 2956-2967.
15. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med, 2012, 366(17): 1567-1576.
16. Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg, 2021, 31(4): 1579-1589.
17. Topart P, Becouarn G, Finel JB. Comparison of 2-year results of Roux-en-Y gastric bypass and transit bipartition with sleeve gastrectomy for superobesity. Obes Surg, 2020, 30(9): 3402-3407.
18. Topart P, Becouarn G, Finel JB. Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures. Surg Obes Relat Dis, 2020, 16(4): 497-502.
19. 姚立彬, 邵永, 洪健, 等. 腹腔镜胃袖状切除联合双通路手术41例短期疗效分析. 中国实用外科杂志, 2021, 41(9): 1024-1028.
20. Liu P, Widjaja J, Dolo PR, et al. Comparing the anti-diabetic effect of sleeve gastrectomy with transit bipartition against sleeve gastrectomy and Roux-en-Y gastric bypass using a diabetic rodent model. Obes Surg, 2021, 31(5): 2203-2210.
21. Hosseini SV, Moeinvaziri N, Medhati P, et al. The effect of single-anastomosis sleeve ileal (SASI) bypass on patients with severe obesity in three consecutive years. World J Surg, 2022, 46(11): 2744-2750.
22. Emile SH, Madyan A, Mahdy T, et al. Single anastomosis sleeve ileal (SASI) bypass versus sleeve gastrectomy: a case-matched multicenter study. Surg Endosc, 2021, 35(2): 652-660.
23. Hosseini SV, Moeinvaziri N, Medhati P, et al. Optimal length of biliopancreatic limb in single anastomosis sleeve gastrointestinal bypass for treatment of severe obesity: efficacy and concerns. Obes Surg, 2022, 32(8): 2582-2590.
24. Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg, 2020, 30(4): 1437-1445.
25. Taskin HE, Al M. Testosterone changes in men with obesity and type 2 diabetes 6 months after sleeve gastrectomy with transit bipartition. Surg Laparosc Endosc Percutan Tech, 2022, 32(2): 188-196.
26. 舒畅, 姚立彬, 洪健, 等. 3种不同减重手术方式治疗肥胖合并糖尿病肾病大鼠的疗效差异对比分析. 中国普外基础与临床杂志, 2023, 30(9): 1063-1072.
27. Al M, Taskin HE. Sleeve gastrectomy with transit bipartition in a series of 883 patients with mild obesity: early effectiveness and safety outcomes. Surg Endosc, 2022, 36(4): 2631-2642.
28. Mahdy T, Emile SH, Madyan A, et al. Evaluation of the efficacy of single anastomosis sleeve ileal (SASI) bypass for patients with morbid obesity: a multicenter study. Obes Surg, 2020, 30(3): 837-845.
29. Salama TMS, Sabry K, Ghamrini YE. Single anastomosis sleeve ileal bypass: new step in the evolution of bariatric surgeries. J Invest Surg, 2017, 30(5): 291-296.
30. Kermansaravi M, Kabir A, Pazouki A. 1-year follow-up of single anastomosis sleeve ileal (SASI) bypass in morbid obese patients: efficacy and concerns. Obes Surg, 2020, 30(11): 4286-4292.
31. Bhandari M, Fobi MAL, Buchwald JN, et al. Standardization of bariatric metabolic procedures: world consensus meeting statement. Obes Surg, 2019, 29(Suppl 4): 309-345.
32. Emile SH, Mahdy T. Excessive weight loss and hypoalbuminemia after SASI bypass: the need for standardization of the technique. Obes Surg, 2021, 31(2): 865-866.
33. Hosseini SV, Haghighat N, Kamran H, et al. Braun anastomosis: a technique for bile reflux improvement after single anastomosis sleeve ileal (SASI) bypass; a pilot study. Surg Innov, 2023, 30(3): 297-302.
34. Rezaei MT, Sheikhbahaei E, Zefreh H, et al. Single-anastomosis sleeve jejunal: a mid-term follow-up report of a new surgical technique. Obes Surg, 2023, 33(4): 1245-1252.
35. Wang M, Widjaja J, Dolo PR, et al. The protective effect of transit bipartition and its modification against sleeve gastrectomy-related esophagitis in a rodent model. Obes Surg, 2022, 32(4): 1149-1156.
36. 朱孝成, 姚立彬. 胃袖状切除术联合双通道术的价值与存在问题. 中国实用外科杂志, 2023, 43(5): 523-528.

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Prospects and considerations of sleeve gastrectomy with transit bipartition

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