Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model

Obes Surg. 2016 Apr;26(4):797-804. doi: 10.1007/s11695-015-1811-7.


Background: Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Methods: Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB. Their body weights, food intake, and levels of gut hormones (ghrelin, insulin, and glucagon-like peptide-1 (GLP-1)) and lipids were measured.

Results: Rats in the SG, JI-SG, and RYGB groups demonstrated lower food intake and more weight loss 2 weeks postoperatively compared with control rats. Furthermore, rats in the JI-SG group achieved more weight loss (mean 242.7 ± 11.2 g) compared with those in the SG and RYGB groups (SG, 401.4 ± 15.1 g and RYGB, 298 ± 12 g, both P < 0.01). All surgery groups demonstrated a decreased fasting insulin, serum glucose, lipid levels, and increased GLP-1 postoperatively. The JI-SG group had lower fasting ghrelin levels than the RYGB group (168 ± 19.8 ng/L vs. 182 ± 16.7 ng/L, P < 0.01) and higher fasting GLP-1 levels than the SG group (1.99 ± 0.11 pmol/L vs. 1.71 ± 0.12 pmol/L, P < 0.01) at 12 weeks postoperatively. Over the experimental period, the ghrelin levels slowly increased in all surgical groups but remained lower than the preoperative and control levels.

Conclusions: JI-SG induced higher ghrelin and GLP-1 levels and improved glycemic control in Zucker diabetic fatty rats. Compared with SG and RYGB, JI-SG appeared to be a simple, relatively safe, and more effective procedure for treating type 2 diabetes and obesity in this animal model.

Keywords: Jejunoileal anastomosis; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes; Zucker diabetic fatty rat.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anastomosis, Surgical*
  • Animals
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / surgery*
  • Disease Models, Animal
  • Eating
  • Fasting
  • Gastrectomy / methods*
  • Glucagon-Like Peptide 1 / blood
  • Ileum / surgery*
  • Insulin / blood
  • Jejunum / surgery*
  • Lipids / blood
  • Male
  • Obesity / surgery
  • Random Allocation
  • Rats
  • Rats, Zucker


  • Blood Glucose
  • Insulin
  • Lipids
  • Glucagon-Like Peptide 1