Short-term efficacy of laparoscopic sleeve gastrectomy with transit bipartition versus laparoscopic sleeve gastrectomy in the treatment of super obesity

doi:10.16139/j.1007-9610.2026.02.05

Abstract

Abstract:

Objective To compare the short-term efficacy and safety of laparoscopic sleeve gastrectomy (LSG) with transit bipartition (TB) versus LSG in super obese patients. Methods A retrospective study was conducted on 113 super obese patients (LSG 75, LSG-TB 38 cases), evaluating weight loss, metabolic outcomes, nutritional indicators, and complications over 12 months. Results At 12 months, LSG-TB showed significantly higher percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL) than LSG (40.0% vs. 36.6%, 73.4% vs. 66.2%, P<0.05). Both groups achieved similar glycemic control, while total cholesterol (TC), low density lipoprotein (LDL), and uric acid (UA) levels decreased more in the LSG-TB group (P<0.05). Gastroesophageal reflux disease (GERD) remission was significantly better with LSG-TB (P<0.05). Postoperative complication rates were low in both groups, with stable nutritional status. Conclusions LSG-TB demonstrates superior short-term weight loss and metabolic benefits in super obese patients, with comparable safety to LSG, supporting its clinical value.

Key words: Super obesity, Laparoscopic sleeve gastrectomy (LSG), Transit bipartition(TB), Bariatric surgery, Metabolic benefit

CLC Number:

ZHU Yuxi, NI Liangchen, WANG Jian, HONG Jian, ZHU Xiaocheng, YAO Libin. Short-term efficacy of laparoscopic sleeve gastrectomy with transit bipartition versus laparoscopic sleeve gastrectomy in the treatment of super obesity[J]. Journal of Surgery Concepts & Practice, 2026, 31(02): 121-128.

Figures/Tables 7

Fig 1

Tab 1

Tab 2

Fig 2

Tab 3

Comparison of blood glucose, UA and lipid metabolic parameters ($\bar{x}\pm s$)

Variable	LSG	LSG-TB	t/P value^a)	t/P value^b)	t/P value^c)
Baseline
FBG（mmol/L）	6.2±2.2	6.6±1.9	-	-	-0.989/0.325
TG（mmol/L）	1.8±0.9	2.0±1.1	-	-	-1.089/0.279
TC（mmol/L）	4.7±1.0	4.7±1.2	-	-	-0.275/0.784
UA（μmol/L）	452.9±107.8	424.1±106.0	-	-	1.322/0.189
HDL（mmol/L）	1.0±0.2	1.0±0.2	-	-	-1.051/0.298
LDL（mmol/L）	2.9±0.9	3.0±0.6	-	-	-0.695/0.490
HbA1c（%）	6.4±1.4	6.8±1.4	-	-	-1.396/0.166
1 month
FBG（mmol/L）	5.5±0.9	5.8±0.8	-2.121/0.040	-1.168/0.262	-1.017/0.313
TG（mmol/L）	1.5±0.4	1.8±0.7	-2.439/0.020	-1.572/0.136	-2.015/0.048
TC（mmol/L）	4.4±0.8	4.7±1.0	-2.383/0.022	-0.814/0.427	-1.060/0.293
UA（μmol/L）	496.0±110.8	428.8±86.3	1.634/0.112	-1.397/0.182	2.252/0.029
HDL（mmol/L）	1.1±0.5	1.0±0.2	1.172/0.260	-1.735/0.103	1.003/0.323
LDL（mmol/L）	2.6±0.9	3.0±0.8	-1.983/0.065	-0.728/0.478	-1.279/0.210
HbA1c（%）	5.8±0.6	5.8±0.7	-3.803/0.001	-4.335/0.007	-0.007/0.994
6 months
FBG（mmol/L）	5.1±0.6	5.0±0.5	-4.040/<0.001	-1.529/0.152	0.465/0.644
TG（mmol/L）	1.1±0.4	1.2±0.5	-3.404/0.002	-2.757/0.017	-0.151/0.880
TC（mmol/L）	4.5±0.9	4.0±0.6	-0.874/0.391	-1.051/0.314	1.738/0.091
UA（μmol/L）	378.5±91.1	373.4±63.0	-1.972/0.061	-3.998/0.002	1.171/0.866
HDL（mmol/L）	1.0±0.1	1.0±0.2	0.752/0.471	0.462/0.655	-0.003/0.997
LDL（mmol/L）	2.5±0.9	2.4±0.6	-1.361/0.207	-1.169/0.276	0.287/0.776
HbA1c（%）	5.3±0.2	5.1±0.3	-2.904/0.017	-2.730/0.052	1.420/0.179
12 months
FBG（mmol/L）	4.9±0.5	4.9±0.5	-3.212/0.003	-5.328/<0.001	0.616/0.540
TG（mmol/L）	0.9±0.4	1.0±0.4	-5.447/<0.001	-4.159/<0.001	-0.570/0.572
TC（mmol/L）	4.6±0.7	3.6±0.7	-.950/0.351	-2.932/0.008	4.565/<0.001
UA（μmol/L）	377.1±76.5	310.5±74.3	-3.319/0.005	-4.123/<0.001	2.558/0.015
HDL（mmol/L）	1.2±0.2	1.2±0.3	3.552/0.004	2.181/0.043	0.848/0.402
LDL（mmol/L）	2.7±0.9	2.0±0.5	-1.397/0.188	-5.713/<0.001	2.907/0.006
HbA1c（%）	5.1±0.4	4.8±0.6	-2.646/0.023	-6.059/0.004	1.087/0.294

Tab 3

Fig 3

Tab 4

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Variable	LSG （n=75）	LSG-TB （n=38）	t/χ² value	P value
Age (year)	30.2±8.1	31.2±5.1	t=-0.705	0.483
Gender(male/female)	28（37.3）/47（62.7）	11（28.9）/27（71.1）	χ²=0.785	0.376
BMI（kg/m²）	54.2±4.5	53.1±3.5	t=1.330	0.186
T2DM	27（36.0）	20（52.6）	χ²=2.872	0.090
Hypertension	25（33.3）	18（47.4）	χ²=2.108	0.147
GERD	9（12.0）	6（15.8）	χ²=0.315	0.575

Variable	LSG （n=75）	LSG-TB （n=38）	t value	P value
Operative time (min)	101.9±21.1	143.0±19.5	-8.721	<0.001
Postoperative hospital stay (d)	2.6±0.9	2.7±0.9	-1.117	0.907
Perioperative complications	1（1.3）	1（2.6）	-	>0.999

Variable	LSG	LSG-TB	χ² value	P value
T2DM remission	22/27（81.5）	18/20（90.0）	-	0.682
Hypertension remission	23/25（92.0）	17/18（94.4）	-	>0.999
GERD remission	2/9（22.2）	5/6（83.3）	-	0.041
Constipation	16/75（21.3）	1/38(2.6)	-	0.01
Diarrhea	4/75（5.3）	9/38（23.7）	6.637	0.01
Malodorous flatus	27/75（32.0）	20/38（52.6）	2.872	0.09