Objective To investigate the clinical efficacy of laparoscopic sleeve gastrectomy plus jejunojejunal bypass (LSG‑JJB) in the treatment of obesity.

Methods The retrospective and descriptive study was conducted. The clinical data of 234 patients with obesity who were admitted to Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from January 2023 to June 2024 were collected. There were 84 males and 150 females, aged (29±7) years, with body mass index as 46(44,49) kg/m². All patients underwent LSG‑JJB performed by the same chief surgeon team. Observation indicators: (1) surgical conditions; (2) weight loss conditions; (3) improvements in glycolipid metabolism and comorbidities. Paired samples Wilcoxon test was used to compare measurement data with skewed distribution before and after surgery.

Results (1) Surgical condi-tions: all 234 patients underwent LSG‑JJB successfully, without conversion to open surgery, intestinal obstruction, or perioperative death. The incidence of postoperative bleeding was 0.85%(2/234), and the incidence of gastric leakage was 0.43%(1/234). The 2 patients with postoperative bleeding were cured by conservative treatment without reoperation. One case of delayed gastric leakage occurred on the 79th postoperative day and was discharged after emergency surgery. (2) Weight loss conditions: all 234 patients were followed up for 12 months after surgery. The preoperative body weight and body mass index were 134(117,149) kg and 46(44,49) kg/m², respectively, versus 82(74,94) kg and 29(26,33) kg/m² at 1 year after surgery, showing significant differences before and after surgery (Z=-13.26, -13.26, P<0.05). The percentage of total weight loss and percentage of excess weight loss of patients at 1 year after surgery were 36%±8% and 83%±29%, respectively. (3) Impro-vements in glycolipid metabolism and comorbidities: from pre‑operation to 1 year after surgery, the systolic blood pressure changed from 141(131,153) mmHg (1 mmHg=0.133 kPa) to 117(105,131) mmHg, diastolic blood pressure from 91(83,100) mmHg to 77(69,83) mmHg, glycosylated hemoglobin from 6.5%(6.0%,7.6%) to 5.3%(5.1%,5.5%), fasting blood glucose from 6.0(5.1,8.1) mmol/L to 4.7(4.4,4.9) mmol/L, fasting insulin from 24(17,32) μIU/mL to 7(4,11) μIU/mL, triglycerides from 1.7(1.2,2.6) mmol/L to 0.9(0.7,1.0) mmol/L, total cholesterol from 4.9(4.4,5.5) mmol/L to 4.6(4.1,5.2) mmol/L, high‑density lipoprotein cholesterol from 1.1(0.9,1.2) mmol/L to 1.3(1.2,1.6) mmol/L, low‑density lipoprotein cholesterol from 3.2(2.7,3.6) mmol/L to 2.9(2.4,3.3) mmol/L, alanine aminotransferase from 60(40,85) U/L to 14(10,17) U/L, aspartate aminotransferase from 39(28,55) U/L to 16(14,19) U/L, and uric acid from 437(389,511) μmol/L to 350(279,408) μmol/L, showing significant differences in the above indicators before and after surgery (Z=-8.09, -7.47, -8.98, -8.18, -6.21, -9.29, -3.19, -8.94, -3.93, -9.35, -9.16, -8.32, P<0.05). Among 85 patients with preoperative diabetes mellitus, the complete remission rate of diabetes mellitus at 1 year after surgery was 97.6%(83/85), and the partial remission rate was 100.0% (85/85).

Conclusion LSG‑JJB has a definite short‑term efficacy and controllable safety in the treatment of obesity and metabolic diseases.