Duodenal‐Jejunal Bypass Stent Versus Laparoscopic Sleeve Gastrectomy in Patients With Obesity and MASLD : Short‐Term Efficacy and Perioperative Safety in a Retrospective Cohort Study

AIMS: Obesity is a critical risk factor for progression of metabolic dysfunction-associated steatotic liver disease (MASLD). Laparoscopic sleeve gastrectomy (LSG) and duodenal-jejunal bypass stent (DJBS) are two major weight-loss modalities, yet comparative evidence remains limited. MATERIALS AND METHODS: Patients receiving bariatric interventions were retrospectively analysed. The patients were grouped according to different surgical methods, and the demographic data, anthropological characteristics, treatment plans and prognosis of the patients were compared and analysed. RESULTS: A total of 96 patients were included in this study, with 31 patients in the DJBS group and 65 patients in the LSG group. The mean age of the DJBS group was 38.23 ± 9.93 years, and 19 patients (61.3%) were female. The absolute weight loss at 3 months was 8.29 ± 6.47 kg in the DJBS group and 17.66 ± 6.36 kg in the LSG group, with a statistically significant difference (p < 0.001). DJBS achieved superior reductions in LDL-C, fasting glucose and glycated haemoglobin and comparable outcomes for other metabolic markers. The overall post-procedural complication rate was similar between DJBS and LSG (8.99% vs. 18.85%, p = 0.424). Clavien-Dindo Grade I adverse events were less frequent in the DJBS group (p = 0.007). Multiple linear regression analysis demonstrated that surgical procedure (LSG vs. DJBS) (β = 8.458, p < 0.001) and preoperative waist circumference (β = 0.078, p = 0.038) were independent factors associated with post-procedural weight loss. CONCLUSIONS: DJBS produces moderate short-term weight loss with better perioperative safety, while LSG achieves greater weight reduction. Both interventions were associated with comparable short-term changes in liver-related biochemical markers.