Моdified biliopancreatic shunting in the treatment of metabolic syndrome and diabetes mellitus type II in patients with morbid obesity


  • O. Yu. Usenko Shalimov National Institute of Surgery and Transplantology, Kyiv, Shupyk National Medical Academy of Postgraduate Education, Kyiv https://orcid.org/0000-0003-4957-4104
  • O. A. Lavryk Shalimov National Institute of Surgery and Transplantology, Kyiv, Shupyk National Medical Academy of Postgraduate Education, Kyiv https://orcid.org/0000-0001-6779-785X
  • A. Yu. Zgonnyk Shalimov National Institute of Surgery and Transplantology, Kyiv, https://orcid.org/0000-0002-2237-2492
  • M. V. Manoylo Shalimov National Institute of Surgery and Transplantology, Kyiv,
  • A. S. Lavryk Shalimov National Institute of Surgery and Transplantology, Kyiv, https://orcid.org/0000-0002-2216-5039
Keywords: biliopancreatic shunting; metabolic syndrome; оbesity

Abstract

Objective. Studying of the impact of the biliopancreatic shunting (BPSH) operation on the metabolic syndrome (MS) course in patients with morbid obesity (MО).

Маterials and methods. The results of surgical treatment of 76 patients, suffering МО, to whom the BPSH operation was performed in the Institute, were analyzed. The patients, ageing 23 - 65 yrs old, have had the average body mass index (BMI) 57 (44 - 87) kg/m2. Аrterial hypertension have had 49 (64%), dyslipidemia - 53 (70%), the sleep apnea - 13 (17%), аsthma - 14 (18%), diabetes mellitus (DM) type II - 30 (39%) patients. The average time of follow-up have constituted 36 mo. Antropometric and clinical parameters, іndex of insulinresistence (НОМА -Нomeostasis Model Assessment), levels of insulin, glucose, С-peptide and cholesterol in 1, 3, 6 and 12 mo postoperatively were determined.

Results. In 3 mo after BPSH the average BMI have constituted 45.3 (34 - 59), in 6 mo - 36.1 (39 - 55), in 9 mo - 34.2 (33 - 42) kg/m2. Before the operation the НОМА index have constituted (7/6 ± 0/4) conventional units, the average level of a glycemia on an empty stomach - (7.8 ± 0.4) mmol/l, іnsulin - (21.2 ± 2.5) mcIU/ml, glycated hemoglobin (HbA1с) - (6.8 ± 0.3)%. In 36 mo after the operation the НОМА index, levels of glycemia on an empty stomach, of insulin on an empty stomach, С-peptide and HbA1с have had normalized. The levels of a general cholesterole and atherogenic lipids have been reduced gradually to normal values.

Conclusion. BPSH provides a long-standing and effective lowering of the body mass with correction of the MS components.

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Author Biographies


O. Yu. Usenko, Shalimov National Institute of Surgery and Transplantology, Kyiv, Shupyk National Medical Academy of Postgraduate Education, Kyiv

Usenko Olexander Yu - MD. Dr.Sc. Professor,
Director of the O.O. Shalimov National Institute of Surgery and Transplantology
Address: 30 Heroiv Sevastopolia Str., 03680, Kyiv, Ukraine,
 tel.: +38 (044)4971374
usenko1962@gmail.com
ORCID https://orcid.org/0000-0003-4957-4104


O. A. Lavryk, Shalimov National Institute of Surgery and Transplantology, Kyiv, Shupyk National Medical Academy of Postgraduate Education, Kyiv

Lavryk Olga A., MD
General surgery resident
A.A. Shalimov National Institute of Surgery and Transplantology,
Shupyk National Medical Academy of Postgraduate Education
9 Dorohozhytska Str., Kyiv, 04112
+38044 4403371
dr.olgalavryk@gmail.com
ORCID: https:\\0000-0001-6779-785X


A. Yu. Zgonnyk, Shalimov National Institute of Surgery and Transplantology, Kyiv,

MD, PhD (Med)
Surgeon of Department of surgery of esophagus, stomach and intestines
O. O. Shalimov National Institute of Surgery and Transplantology,
30 Heroyv Sevastopolya Str., 03126, Kyiv, Ukraine
+38044 4542008
a.z@ua.fm
ORCID https:\\0000-0002-2237-2492


A. S. Lavryk, Shalimov National Institute of Surgery and Transplantology, Kyiv,

MD. Dr.Sc. Professor
Chief Researcher of Department of surgery of esophagus, stomach and intestines
O.O. Shalimov National Institute of Surgery and Transplantology,
30 Heroyv Sevastopolya Str., 03126, Kyiv, Ukraine
+38044 408 27 66

ORCID https:\\0000-0002-2216-5039

Published
2018-10-29
How to Cite
Usenko, O. Y., Lavryk, O. A., Zgonnyk, A. Y., Manoylo, M. V., & Lavryk, A. S. (2018). Моdified biliopancreatic shunting in the treatment of metabolic syndrome and diabetes mellitus type II in patients with morbid obesity. Klinicheskaia Khirurgiia, 85(10), 5-9. https://doi.org/10.26779/2522-1396.2018.10.05
Section
General Problems of Surgery