الفهرس 
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Abstract
The present study is a case control study which included two groups of diabetic obese patients undergoing laparoscopic gastric bypass or sleeve gastrectomy in the General surgery department at Sohag University Hospital. In the study, 52 obese patients with diabetes mellitus were included (26 in each group).
The mean age was 43.69±7.08 and 39.58±7.69 between bypass and sleeve respectively. There was a statistically significant difference between bypass and sleeve. There were (61.54% and 65.38%) females and (38.46% and 34.62%) males between the bypass and sleeve respectively. There was no statistically significant difference between bypass and sleeve. There were (88.46% and 65.38%) married and (11.52% and 34.62%) single respectively. There was a statistically significant difference between bypass and sleeve.
The mean time of surgery was 114.69±14.08 and 91.04±12.37 between bypass and sleeve respectively. There was a statistically significant difference between bypass and sleeve. There were 42.31% and 15.38% drain between bypass and sleeve respectively. There was a statistically significant difference between bypass and sleeve. There were 15.38% and 3.85% stayed for three days in hospital staying duration. There was a statistically significant difference between the bypass and sleeve. There were 7.69% and 3.85% had post operative bleeding between bypass and sleeve respectively. There was no statistically significant difference between bypass and sleeve.
The mean weight after 2 weeks was 118.08±17.61 and 116.77±12.95 bleeding between bypass and sleeve respectively. There was no statistically significant difference between bypass and sleeve. The mean weight after 4 weeks was 109.04±16.16 and 110.65±12.71 between bypass and sleeve respectively. There was no statistically significant difference between bypass and sleeve. The mean weight after 1 year was 61.69±5.14 and 72.42±7.71 between bypass and sleeve respectively. There was a statistically significant difference between the bypass and sleeve. The mean percentage of weight loss after 1 year was 90.77±3.92 and 69.62±12.24 between bypass and sleeve respectively. There was a statistically significant difference between the bypass and sleeve.
The mean weight after 2 weeks was 119.94±16.26, 108.25±13.5 and 119.6±25.08 among mini bypass, roux bypass and Sasi bypass respectively. There was no statistically significant difference between the three studied groups regarding weight after 2 weeks. The mean weight after 4 weeks was 110.82±14.66, 100±13.24 and 110.2±23.34 among mini bypass, roux bypass and Sasi bypass respectively. There was no statistically significant difference between the three studied groups regarding weight after 4 weeks. The mean weight after a year was 61.29±5, 61.25±9.99 and 63.4±4.93 among mini bypass, roux bypass and Sasi bypass respectively. There was no statistically significant difference between the three studied groups regarding weight after a year. The mean percentage of weight loss after a year was 89.71±4.13, 95±0 and 91±2.23 among mini bypass, roux bypass and Sasi bypass respectively. There was a statistically significant difference between the three studied groups regarding percentage of weight loss after a year.
Conclusions
Gastric bypass was associated with better outcomes compared to sleeve gastrectomy in diabetes mellitus obese patients. This is observed in more weight loss after 1-year, better HbA1c after 3, 6 months and 1 year and better lipid profile after 3 months. Regarding types of bypasses, Roux bypass was associated with more weight loss compared to SASI, and mini bypass. However, no difference was observed regarding sugar and lipid profile.
Recommendations
• Sample size is required to be larger in further studies to produce more accurate results.
• Multi-center studies are recommended.
• Close monitoring of complications’ occurrence is required.
• Increase the follow-period is recommended.