제2형 당뇨병을 동반한 국내 고도비만 환자에서 대사비만 수술의 효과

• Published in: Annals of surgical treatment and research Vol. 79; no. 1; pp. 8 - 13
• Main Authors: 이홍찬(Hongchan Lee), 김미경(Mikyoung Kim), 권혁상(Hyuksang Kwon), 송기호(Kiho Song), 김응국(Eungkook Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.07.2010
• Subjects: 일반외과학; Improvement of type 2 diabetes mellitus; Laparoscopic adjustable gastric banding(LAGB); 복강경 루와이 위우회술; Laparoscopic Roux-en-Y gastric bypass(LRYGB); 복강경 조절형 위밴드 삽입술; 제2형 당뇨병의 호전
• ISSN: 2288-6575; 2288-6796

Purpose: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are the most effective intervention and cure in achieving sustained weight loss in the morbidly obese with co-morbities, especially in type 2 diabetes mellitus (DM). Currently, there are few data in the literature presenting early diabetic outcomes between the 2 major bariatric surgeries in Korea. The aim of this study is to observe weight loss, improvement of type 2 DM after LRYGB and LAGB. Methods: 33 retrospective data were obtained from diabetic subjects undergoing LRYGB (n=53) and LAGB (n=77). These measurements included age, sex, body mass index (BMI), pre-operative diabetic duration, post-operative diabetic at follow-up visit after surgery. Paired t-test, and SPSS12.0 were used for statistical analysis. Results: 33 morbidly obese patients with type 2 DM who had both procedures complain of general weakness. Most patients were taking oral medications or insulin and tired of them. Pre and post-op 12 months of percent of excess weight loss (%EWL), fetal bovine serum (FBS), hemoglobin A1c (HbA1C) presented at 0%, 185.6 mg/dl, 8.7% and 70.6%, 123.4 mg/dl, 6.6% in patients who had LRYGB (P＜0.05). Pre and post-op 12 months of %EWL, FBS, HbA1C presented at 0%, 180.6 mg/dl, 8.4% and 32.8%, 136.5 mg/dl, 6.8% in patients who had LAGB (P＜0.05). Rate of discontinuance or decreasing for treatment of type 2 DM after surgery showed 94% for LRYGB versus 80% for LAGB, and unchanged rates were 6% versus 20%, respectively. Conclusion: This study showed LRYGB and LAGB are quite satisfactory and promising bariatric procedures with significant weight loss and improvement of type 2 DM in Koreans. LRYGB is significantly associated with more weight loss, more diabetic outcome than LAGB. Clinical experiences in Korea with both procedures are limited and a larger number of cases are need, but the recent data shows promising results that are comparable to the international experience. KCI Citation Count: 6