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Review
, 2015, 152852

Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

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Review

Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Yingjun Quan et al. Gastroenterol Res Pract.

Abstract

Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB) in weight loss and type 2 diabetes mellitus (T2DM) control still exist. Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD) and/or odds ratio with 95% confidence interval (95% CI) were used to evaluate the overall size effect. Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, -6.58 (95% CI, -9.37, -3.79), P < 0.01 (LAGB); 2.86 (95% CI, 1.40, 5.83), P = 0.004 (LSG); 10.33 (95% CI, 4.30, 16.36), P < 0.01 (LRYGB)] and comparable/higher T2DM remission results [86.2% versus 55.6%, P = 0.06 (LAGB); 89.1% versus 76.3%, P = 0.004 (LAGB); 93.4% versus 77.6%, P = 0.006 (LAGB)]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, -35.2 (95% CI, -46.94, -23.46)]. Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.

Figures

Figure 1
Figure 1
Flowchart of literature searching and study selection.
Figure 2
Figure 2
Meta-analysis comparing LMGB with LAGB. (a) Remission rate of T2DM. (b) Postoperative BMI. (c) Postoperative waist circumference. The estimates of the weighted risk ratio/mean difference in each study corresponded to the middle of each square and the horizontal line gave the 95% CI. The summary risk ratio/mean difference was represented by the middle of the solid diamond.
Figure 3
Figure 3
Meta-analysis comparing LMGB with LSG. (a) 1-year postoperative %EWL. (b) Overall remission rate of T2DM. (c) Revision surgery rate. (d) 1-year postoperative BMI.
Figure 4
Figure 4
Meta-analysis comparing LMGB with LRYGB. (a) Operation time. (b) 1-year postoperative %EWL. (c) Overall remission rate of T2DM.

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