Background

This multicenter prospective RCT aims to determine the effect of long-limb Roux-en-Y gastrojejunostomy following radical distal gastrectomy in early gastric cancer patients with type II diabetes.

Methods

The length of biliopancreatic and Roux limb will be increased to over 80 centimeters respectively in the long-limb group and the effect on glycemic control will be evaluated compared to the conventional group. Inclusion criteria consisted of clinical stage I gastric cancer less than 80 years old with type II diabetes and body mass index more than 23 obese patients. The primary endpoint is the rate of more than improvement in diabetic control.

Results

The average BMI in both groups was 28, and there was no difference in HbA1C and duration of diabetes. In both groups, HbA1C and FBS decreased at 1, 3, 6, and 12 months after surgery, but there was no significant difference between the two groups. In nutritional indicators, BMI and hemoglobin decreased but there was no significant difference and albumin continued to be maintained. Diabetes control indicators showed statistically more significant improvement in the long-limb group compared to the conventional group at 6 and 12 months after surgery (77.1% vs 48.8%, p=0.028)

Conclusions

From above results, we are expecting the simultaneous control of gastric cancer & type 2 diabetes analyzing the relationship between diabetes control & length of bypass and hope to make efficacy of metabolic surgery in non-morbidly obese population in the future.