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Greater Curvature Plication with Duodenal–Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus

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Abstract

Objective

The study investigated the use of great curvature plication with duodenal–jejunal bypass (GCP-DJB) in a type 2 diabetic with obesity rat model.

Methods

Twenty-two Sprague-Dawley rats were given a high fat and sugar diet with subsequent intraperitoneal injection of a small dosage of streptozotocin (30 mg/kg) and randomly assigned to either GCP-DJB (n = 12) or Sham surgery (n = 10). Body weight, peripheral blood glucose, and fasting serum insulin were assayed, and insulin resistance index (IRI) was calculated, before and at 1, 2, 4, and 8 weeks after surgery.

Results

No differences were found in the preoperative characteristics of the two groups (P > 0.05). At week 1, the body weights decreased significantly, but there was no significant difference between the two groups (P > 0.05).The fasting blood glucose was significantly lower in the GCP-DJB than in the Sham group (P < 0.05), serum insulin levels were higher (P < 0.05), and IRI began to decline (P < 0.05). From 2 to 8 weeks, the body weight of Sham group gradually recovered and continued to rise, while the GCP-DJB group remained at a relatively lower state. Compared to the Sham group, the body weight, fasting blood glucose as well as IRI of GCP-DJB rats had significantly decreased (P < 0.05). But, the fasting insulin concentrations had significantly increased (P < 0.05).

Conclusion

This novel GCP-DJB procedure established a stable animal model for the study of metabolic surgery to treat type 2 diabetes mellitus (T2DM).

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Acknowledgements

This work was supported by grants from the NSFC (Natural Science Foundation of China) No. 81300723, No.81270969, and No.81370984. Nian-Cun Qiu, Xiao-Xia Cen, and Miao-E Liu had the original conception, carried out the experimental work, and wrote the article. They contributed equally to this work and should be considered as co-first authors. Si-Luo Zha and Ling-Di Wang participated in the data analysis and interpretation. Cheng-Xiang Shan and Wei Zhang participated in data collection and coordination of experimental work. Qing Liu, Yang Wang, and Ming Qiu were involved in the revision of the article. Yang Wang and Ming Qiu were the corresponding authors. All authors had read and approved the final manuscript.

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Author notes

  1. Nian-Cun Qiu, Xiao-Xia Cen, and Miao-E Liu contributed equally to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Department of General Surgery, Hainan Branch of Chinese PLA General Hospital, Sanya, 572000, China

    Nian-Cun Qiu, Qing Liu & Ling-Di Wang

  2. Department of General Surgery, Chang Zheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China

    Nian-Cun Qiu, Xiao-Xia Cen, Si-Luo Zha, Cheng-Xiang Shan, Wei Zhang & Ming Qiu

  3. Key Laboratory of Reproductive Genetics, Women’s Hospital, Zhejiang University, Zhejiang, 310000, China

    Miao-E Liu

  4. Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese PLA General Hospital, Beijing, 100000, China

    Yang Wang

  5. Department of Organ Transplantation, Chang Zheng Hospital affiliated to Second Military Medical University, Shanghai, 200003, China

    Yang Wang

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  1. Nian-Cun Qiu
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Corresponding author

Correspondence to Yang Wang.

Ethics declarations

Informed Consent

Informed consent was obtained from individual participants included in the study.

Animal Rights Statement and Ethical Approval

This study was approved by the Animal Ethics Committee of Changzheng Hospital Affiliated to the Secondary Military Medical University. For this type of study, formal consent is not required.

Conflict of Interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Fig. A

Dissociate the great curvature of stomach (JPEG 6904 kb)

Fig. B

Dissociate the surrounding area of duodenum and pylorus (JPEG 6444 kb)

Fig. C

The unfolded great curvature (JPEG 3692 kb)

Fig. D

First-layer plication (JPEG 4377 kb)

Fig. E

Second-layer plication (JPEG 382 kb)

Fig. F

Disconnect the duodenum and ligate the stump (JPEG 5006 kb)

Fig. G

End-to-side anastomosis (JPEG 4145 kb)

Fig. H

Duodenum–jejunostomy (JPEG 6127 kb)

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Qiu, NC., Cen, XX., Liu, ME. et al. Greater Curvature Plication with Duodenal–Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus. OBES SURG 28, 1595–1601 (2018). https://doi.org/10.1007/s11695-017-3057-z

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  • DOI: https://doi.org/10.1007/s11695-017-3057-z

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