Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers

Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. However, it is unclear just how effective the LRYGB procedure is on T2DM for patients with BMI less than 35 kg/m2. We report one...

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Main Authors: Laura F. Tait, Gezzer Ortega, Daniel D. Tran, Terrence M. Fullum
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2012/102752
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author Laura F. Tait
Gezzer Ortega
Daniel D. Tran
Terrence M. Fullum
author_facet Laura F. Tait
Gezzer Ortega
Daniel D. Tran
Terrence M. Fullum
author_sort Laura F. Tait
collection DOAJ
description Background. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. However, it is unclear just how effective the LRYGB procedure is on T2DM for patients with BMI less than 35 kg/m2. We report one obese patient with T2DM who did not meet the current NIH criteria for morbid obesity surgery. This patient underwent a laparoscopic truncal vagotomy, subtotal gastrectomy, and Roux-en-Y gastrojejunostomy for intractable gastric ulcers and subsequently had full resolution of her T2DM. Methods. A 48-year-old patient with a BMI of 34.6 kg/m2 underwent a laparoscopic truncal vagotomy, subtotal gastrectomy, and Roux-en-Y gastrojejunostomy for intractable gastric ulcers. The patient was seen 3 months preoperatively, followed for 24 months postoperatively, and evaluated for postoperative complications, weight loss, and improvement in comorbidities. Results. The patient had no postoperative surgical complications. Her BMI decreased from 34.6 kg/m2 to 22.3 kg/m2 by 24 months postoperatively. Significant improvements in her fasting blood glucose levels were seen 10 days postoperatively from a preoperative level of 147 mg/dl to 97 mg/dl. Conclusion. Patients with a BMI less than 35 kg/m2 and uncontrolled T2DM may benefit from a laparoscopic Roux-en-Y gastric bypass.
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spelling doaj-art-9f4a230e28434297bfa623ef0ec5024d2025-02-03T05:48:01ZengWileyCase Reports in Surgery2090-69002090-69192012-01-01201210.1155/2012/102752102752Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric UlcersLaura F. Tait0Gezzer Ortega1Daniel D. Tran2Terrence M. Fullum3Howard University College of Medicine, Washington, DC 20059, USADivision of Bariatric and Minimally Invasive Surgery, Howard University Hospital, Washington, DC 20060, USADivision of Bariatric and Minimally Invasive Surgery, Howard University Hospital, Washington, DC 20060, USADivision of Bariatric and Minimally Invasive Surgery, Howard University Hospital, Washington, DC 20060, USABackground. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to be an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. However, it is unclear just how effective the LRYGB procedure is on T2DM for patients with BMI less than 35 kg/m2. We report one obese patient with T2DM who did not meet the current NIH criteria for morbid obesity surgery. This patient underwent a laparoscopic truncal vagotomy, subtotal gastrectomy, and Roux-en-Y gastrojejunostomy for intractable gastric ulcers and subsequently had full resolution of her T2DM. Methods. A 48-year-old patient with a BMI of 34.6 kg/m2 underwent a laparoscopic truncal vagotomy, subtotal gastrectomy, and Roux-en-Y gastrojejunostomy for intractable gastric ulcers. The patient was seen 3 months preoperatively, followed for 24 months postoperatively, and evaluated for postoperative complications, weight loss, and improvement in comorbidities. Results. The patient had no postoperative surgical complications. Her BMI decreased from 34.6 kg/m2 to 22.3 kg/m2 by 24 months postoperatively. Significant improvements in her fasting blood glucose levels were seen 10 days postoperatively from a preoperative level of 147 mg/dl to 97 mg/dl. Conclusion. Patients with a BMI less than 35 kg/m2 and uncontrolled T2DM may benefit from a laparoscopic Roux-en-Y gastric bypass.http://dx.doi.org/10.1155/2012/102752
spellingShingle Laura F. Tait
Gezzer Ortega
Daniel D. Tran
Terrence M. Fullum
Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
Case Reports in Surgery
title Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
title_full Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
title_fullStr Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
title_full_unstemmed Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
title_short Resolution of Uncontrolled Type 2 Diabetes after Laparoscopic Truncal Vagotomy, Subtotal Gastrectomy, and Roux-en-Y Gastrojejunostomy for a Patient with Intractable Gastric Ulcers
title_sort resolution of uncontrolled type 2 diabetes after laparoscopic truncal vagotomy subtotal gastrectomy and roux en y gastrojejunostomy for a patient with intractable gastric ulcers
url http://dx.doi.org/10.1155/2012/102752
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