%0 Journal Article
%T Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats.
%A Han LO
%A Zhou LH
%A Cheng SJ
%A Song C
%A Song CF
%J World J Gastroenterol
%V 17
%N 45
%D Dec 2011 7
%M 22174553
%F 5.374
%R 10.3748/wjg.v17.i45.5021
%X <B>OBJECTIVE: </B>To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass.<BR><B>METHODS: </B>We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These included: use of anatomical markers to precisely identify Treitz's ligament; careful dissection along surgical planes; careful attention to the choice of regional transection sites; reconstruction using full-thickness anastomoses; use of a minimally invasive procedure with prohemostatic pretreatment and hemorrhage control; prevention of hypothermic damage; reduction in the length of the procedure; and accelerated surgical recovery using fast-track surgical modalities such as perioperative permissive underfeeding and goal-directed volume therapy.<BR><B>RESULTS: </B>The series of modifications we adopted reduced operation time from 110.02 ± 12.34 min to 78.39 ± 7.26 min (P < 0.01), and the procedural success rate increased from 43.3% (13/30) to 90% (18/20) (P < 0.01), with a long-term survival of 83.3% (15/18) (P < 0.01).<BR><B>CONCLUSIONS: </B>Using a number of fast-track and damage control surgical techniques, we have successfully established a stable model of gastric bypass in diabetic rats.