Long-term Experience with Loop Duodenojejunal Bypass with Sleeve Gastrectomy at a Single Center in South India

Background: Loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) combines gastric restriction with proximal intestinal bypass and has shown promising metabolic and weight-loss outcomes. Long-term data remain limited. Objective: The objective of this study was to evaluate the long-term safety, efficacy, and nutritional outcomes of LDJB-SG in severe obesity and uncontrolled type 2 diabetes mellitus (T2DM). Materials and Methods: This retrospective single-center study included patients undergoing LDJB-SG between 2014 and 2019. Eligible patients were either aged <50 years with body mass index (BMI) ≥50 kg/m 2 or aged 18–65 years with uncontrolled T2DM and BMI 27.5–35 kg/m 2 . Outcomes were assessed at 1 and 5 years. Results: A total of 150 patients underwent LDJB-SG, including 113 with severe obesity and 37 with uncontrolled T2DM. Follow-up was available for 141 patients (94.0%) at 1 year and 65 (43.3%) at 5 years. Mean preoperative BMI was 49.9 ± 8.6 kg/m 2 . Mean %EWL was 78.4% ±18.4% at 1 year and 69.5% ±12.2% at 5 years. Among 71 diabetic patients, mean HbA1c decreased from 8.9 ± 1.3% preoperatively to 5.9% ±0.9% at 1 year and 6.1% ±0.8% at 5 years ( P < 0.001). Diabetes remission was achieved in 79.7% and 73.2% at 1 and 5 years, respectively. One patient developed a gastroduodenal artery pseudoaneurysm requiring angioembolisation, whereas seven developed port-site seromas. No anastomotic leaks, protein–calorie malnutrition, or mortality occurred. Conclusion: LDJB-SG is a safe and effective bariatric procedure providing durable weight loss, sustained diabetes remission, and acceptable long-term nutritional outcomes.