Jejunoileal side-to-side anastomosis: New hope for patients with type 2 diabetes?

Table 1 Comparison of three most commonly used surgical treatments

	Jejunoileal side-to-side anastomosis	Roux-en-Y gastric bypass	sleeve gastrectomy
Targeting the crowd	It is mainly targeted at T2DM patients with normal or relatively high BMI and comorbidities	It is primarily targeted at T2DM patients with high BMI and comorbidities	It is primarily targeted at T2DM patients with high BMI and with or without comorbidities
Effectiveness	Effectively alleviates T2DM and related comorbidities	Significant weight loss and effective reduction of T2DM and related comorbidities	The weight loss outcomes were substantial; however, the improvement in comorbidities was less pronounced compared to Roux-en-Y gastric bypass
Safety	It may cause long-term nutrient absorption problems due to intestinal reconstruction, but there are few clinical studies and no obvious data support	Early complications include: Anastomotic leak, hemorrhage obstruction Venous thrombo-embolic disease. Infections: Late complications include: Internal herniation (most common). Stricture. Micronutrient deficiency. Hyperoxaluria. Gallstone formation. Dumping syndrome. Marginal ulcers. Gastrogastric fistula. Failed weight loss maintenance. Roux-en-Y Gastric Bypass has a higher mortality rate of about 0.2% than sleeve gastrectomy	The complication rate is low but there may be problems with gastroesophageal reflux
Cost-effectiveness	Surgery is shorter and hospital stays less, so initial costs are lower, but costs for long-term nutritional management may increase	Although surgery costs are high, medical expenses may be reduced in the long term due to diabetes remission	In between

T2DM: Type 2 diabetes mellitus; BMI: Body mass index.