Braun gastrointestinal bypass surgery exerts similar hypoglycemic effects, with minimal operation time and earlier functional recovery, than Roux-en-Y bypass in type 2 diabetic rats

摘要

Background: Despite the beneficial hypoglycemic and potentially curative effects in type 2 diabetes, large stomach volume deficits caused by Roux-en-Y gastrointestinal bypass (RYGB) surgery increase complications. Hypoglycemic effects of Braun surgery and RYGB surgery, both modified to maximally preserve stomach volume, were compared in rat type 2 diabetes models. Methods: Three-month-old, male Goto-Kakizaki (GK) rats (n = 40) were randomly divided into equal groups and not treated (control) or treated with sham surgery (sham group), modified stomach-preserving Braun gastrointestinal bypass (Braun group), or modified RYGB (RYGB group). Pre- and postoperative body weight and water intake were recorded, along with operative and defecation times. Fasting blood glucose at 12 h, and blood glucose 180 min after intragastric glucose administration, were measured at weeks 1, 2, 3, 4, 10, and 11 along with glycosylated hemoglobin (preoperatively, week 11). Results: Statistically similar (P > 0.05) increased body weight and decreased water intake, fasting blood glucose, blood glucose after intragastric glucose administration, and glycosylated hemoglobin were observed in Braun and RYGB groups compared with control and sham groups (P < 0.05). By week 1, RYGB and Braun groups exhibited sustained reductions in fasting blood glucose from 13.0 ± 4.1 to 6.9 ± 1.4 mmol/L and 12.4 ± 4.4 to 7.3 ± 0.9 mmol/L, respectively (P < 0.05); mean operative times were 139.1 ± 4.9 and 81.6 ± 6.4 min, respectively; and postoperative defecation times were 74.3 ± 3.1 and 29.4 ± 4.1 h, respectively (P < 0.05). Conclusions: Stomach volume-preserving Braun gastrointestinal bypass surgery was faster and produced hypoglycemic effects similar to RYGB bypass surgery, potentially minimizing metabolic disruption.