Obesity and type 2 diabetes mellitus (T2DM) are reaching epidemic proportions worldwide. Only surgical treatment (bariatric surgery) is possible for morbidly obese people. In the majority of patients, bariatric surgery leads to sustained weight loss and relief from accompanying illnesses. One of the most frequently performed bariatric operations is the laparoscopic proximal Roux-en-Y gastric bypass (LRYGB). The metabolic effect of an LRYGB is partly independent of weight loss. The mechanisms underlying the metabolic improvement of bariatric surgery are not yet fully understood.
Aim of the study
Our aim is to investigate whether a longer biliopancreatic limb (BPL) in LRYGB leads to better weight loss and remission of comorbidities in obese patients without compromising safety compared to a standard LRYGB. In addition, the mechanisms that lead to weight reduction and improved metabolism are being investigated in some of the patients. Intestinal hormones, intestinal immune cells and metabolic metabolites are measured before and after the operation.
Who can take part?
Patients aged 18 to 65 years with a BMI between 35-60 kg/m2 for whom bariatric surgery is planned. Patients cannot take part in the study if they have diabetes, a chronic infectious disease, lactose intolerance or are pregnant.
Procedure
Before bariatric surgery, the patient is given a continuous glucose monitor for one week. The patient also keeps a diet and exercise diary for a week. A breath test is carried out to measure the metabolites in the exhaled air. A mixed meal tolerance test is also carried out. The patient also has a colonoscopy with biopsy samples taken from the terminal ileum and transverse colon. These examinations are carried out again 6 months after the operation.
Compensation
500 chf
Original study name
Swiss Multicenter Randomized Controlled Trial on different Limb Lengths in Gastric Bypass Surgery (SLIM-Trial)
BASEC number
2019-02392
Financial support from
SNF