Sleeve Gastrectomy With Jejunojejunal Bypass Versus Sleeve Gastrectomy: 12-Month Outcomes From a Propensity Score-Matched Analysis
In brief
Adding jejunojejunal bypass increased 12-month weight loss by 3.6 percentage points
In a single-center matched cohort, patients who had sleeve gastrectomy with jejunojejunal bypass lost 30.2% of their body weight at 12 months, versus 26.6% after sleeve gastrectomy alone. Differences in metabolic, nutritional, and safety outcomes were inconclusive, and the observational design limits conclusions; the suggested bypass proportion for greatest weight loss needs prospective testing.
- Journal
- Clinical obesity (Q2)
- Published
- 1 December 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Yi Sun, Yi Zhang, Jia-Ming Xue, Hao-Ran Li, Hao-Yu Guan, Li-Ming Tang
- PMID
- 42995006
- DOI
- 10.1111/cob.70125
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (top studies of the week, 8 November 2026): Direct sleeve-based procedure comparison with weight and metabolic outcomes
Abstract
Sleeve gastrectomy is widely used to treat obesity, but inadequate weight loss or weight regain remains a clinical concern. Comparative evidence for sleeve gastrectomy with jejunojejunal bypass (SG-JJB) versus standard sleeve gastrectomy (SG) is limited. This single-centre retrospective cohort compared 12-month outcomes and examined bypass proportion in relation to weight loss. Among 191 propensity score-matched patients (126 SG; 65 SG-JJB), matching-weighted mean percentage total weight loss (%TWL) was 26.59% after SG and 30.16% after SG-JJB. The adjusted difference was 3.55 percentage points (95% CI, 0.36 to 6.74; p = 0.030). After multiplicity adjustment, no clear between-group differences were identified in glycemic, lipid, hepatic, or nutritional outcomes. Recorded complications and complaints were infrequent, limiting comparative safety inference. Among all 70 SG-JJB patients, restricted cubic spline analysis suggested a non-linear association between bypass proportion and %TWL (P for non-linearity = 0.044). The fitted curve peaked at a bypass proportion of 0.359, with predicted %TWL of 35.62% (pointwise 95% CI, 32.86% to 38.39%). This peak was within the observed 10th-to-90th percentile interval of 0.272 to 0.371, although bootstrap analyses indicated uncertainty in its location. In this matched cohort, SG-JJB was associated with greater 12-month weight loss than SG. Evidence for differences in metabolic, nutritional and safety-related outcomes remained inconclusive. The central observed bypass-proportion interval may inform prospective evaluation but not current operative selection.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.