Chinese expert consensus on sleeve gastrectomy with jejunojejunal bypass (SG-JJB): terminology, patient selection, surgical technique, and perioperative management

Abstract Background Sleeve gastrectomy with jejunojejunal bypass (SG-JJB) is an emerging metabolic and bariatric surgical procedure that combines sleeve gastrectomy with jejunojejunal bypass. However, variations in terminology, patient selection, surgical techniques, and perioperative management have limited the standardization of this procedure. This study aimed to develop a Chinese expert consensus to provide standardized recommendations for SG-JJB. Methods A multidisciplinary consensus development group supported a Delphi expert panel composed of bariatric and metabolic surgeons. Evidence was synthesized through a systematic literature review conducted in accordance with the PRISMA guidelines. Twenty-one experts were invited to participate in two rounds of Delphi consultation, followed by an expert panel meeting. Experts rated the importance of each item using a five-point scale. Consensus was predefined as an agreement rate of ≥ 80%, with a coefficient of variation of ≤ 0.25. Results The Chinese expert consensus on SG-JJB included six thematic domains and 16 recommendations covering nomenclature, indications and contraindications, preoperative preparation, surgical configuration, incision closure and drainage, and postoperative management. Recommendations were developed based on available evidence and expert agreement using predefined consensus criteria. Conclusions This evidence-informed Chinese expert consensus provides a reference framework for the terminology, patient selection, surgical technique, and perioperative management of SG-JJB. Given the limited high-quality, procedure-specific evidence, several recommendations represent consensus-informed guidance and require validation in prospective multicenter studies.