Sleeve Gastrectomy With Proximal Jejunal Bypass: Balancing Simplicity and Efficacy in Metabolic and Bariatric Surgery

Sleeve gastrectomy with proximal jejunal bypass (SG-PJB) is a simplified sleeve-plus procedure designed to augment the metabolic impact of sleeve gastrectomy while avoiding the long-term complications associated with Roux-en-Y gastric bypass (RYGB). Early studies demonstrate that SG-PJB achieves diabetes remission and metabolic improvements comparable to RYGB, with sustained insulin independence in previously insulin-dependent patients. The procedure preserves duodenal continuity and maintains physiologic nutrient absorption, and no cases of hypoalbuminemia or bacterial overgrowth have been reported. Despite its promising balance of metabolic efficacy and nutritional safety, further research is required to clarify optimal indications, determine appropriate bypass limb lengths, and validate long-term safety. As current data suggest, SG-PJB offers a favorable risk-benefit profile and may become a valuable alternative within the sleeve-plus spectrum.