Evaluation of the Role of Laparoscopic Sleeve Gastrectomy and Laparoscopic One Anastomosis Gastric Bypass in the Treatment of Metabolic Syndrome

Abstract Background The dramatic rise in the prevalence of Metabolic Syndrome has become a major global health issue. The problem is complex and will require strategies at many levels to prevent, control and manage. It is well known that obesity has profound effect on tissue sensitivity to insulin and so, leads to glucose intolerance, increased in Blood Pressure and abnormalities in Lipid Profile. Patients and Methods We aimed to compare between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy regarding the efficacy of control of type 2 D.M, Hypertension and Hyperlipidemia in obese patients. It is a prospective study which was done between April 2022 – October 2022 at Ain Shams university hospitals, Cairo, Egypt. This study included 60 obese patients with type 2 D.M with one or both of the following (Hypertension and Hyperlipidemia) and divided into two groups: Group (1): (30 patients) treated by laparoscopic Sleeve gastrectomy, group (2): (30 patients) treated by laparoscopic One anastomosis- Gastric Bypass. Results Complete resolution of diabetes occurred in OAGB cases in 66.7% compared to 55.4% in SG cases at 6 months and cases with no remission in D.M was 0% in OAGB and 16.6% with SG. Regarding the Hypertension, in Group 1 (SG) Resolution Of Hypertension was 55%, Improvement was 25% and No Change in Hypertension Status was 20%, In Group 2 (OAGB) Resolution Of Hypertension was 62.5%, Improvement was 25% and No Change in Hypertension Status was 12.5%, with comparing the 2 groups. Regarding Hyperlipidemia. In Group 1 (SG) Resolution Of Hyperlipidemia was 48%, Improvement was 30% and No Change in Hyperlipidemia Status was 22%, In Group 2 (OAGB) Resolution Of Hyperlipidemia was 60%, Improvement was 24% and No Change in Hypertension Status was 16%. Conclusion Bariatric surgery (SG and OAGB) is not only weight reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and they are considered the most effective long term treatment modality for type 2 diabetes in obese patients and with comparing between SG and OAGB, our study suggests that Both procedures are highly effective in control of Diabetes, Hypertension.