Sleeve gastrectomy (SG) with transit bipartition (TB) was applied to a Bulgarian patient for the first time and no other case presentation was found in the literature using this treatment method in Bulgaria. Our aim is to introduce and disseminate this procedure in our country for the treatment of patients with type 2 diabetes mellitus (T2DM).
A 40-year-old gentlemen, height 176 cm, weight 115 kg (BMI: 37.2 kg/m2), presented with a 3-year history of T2DM. His grandmother has T2DM. First, he was admitted in a hospital in Sofia. His Hba1C level was 9.31% and blood glucose was 16 mmol/L. He was on treatment with metformin 850 mg morning and evening 2 times daily. Patient complaints were polyuria, polyphagia, weakness, and headache. He was informed about metabolic surgery and he referred to the clinic in Istanbul willingly to have a surgical operation.
In May 2016, he underwent laparoscopic SG with TB in İstanbul. The patient recovery was successful, and 16 kg weight loss was observed in 4 months. Hba1C value was observed in normal range -6%. He is not on any drug treatment for his T2DM.
Surgical treatment options for diabetes mellitus are available nowadays to treat patients with obesity. The ABCD score, which comprise age, BMI, C-peptide level, and duration of T2DM (years) was reported as useful in predicting the success of T2DM treatment using metabolic surgery. SG with TB operations are getting more popular, but in our country, this is the first case of a patient treated with SG+TB.SG+TB is a simple procedure that results in rapid weight loss and remission or major improvement of comorbidities. As a conclusion of this case report, TB is an excellent complement to SG.