Please select the eligibility criteria that correspond to the clinical trial below.
Title: Prospective Randomized Study of Effects of Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy
Brief Summary: The sleeve gastrectomy that has been utilized as a first-stage bariatric procedure to reduce surgical risk in high-risk patients by induction of weight loss is now gaining popularity as a standalone procedure for the treatment of morbid obesity. It appears to be a technically easier and/or faster laparoscopic procedure than Roux-en-Y gastric bypass. It brings good weight loss results, in some studies even comparable to the RYGB and Biliopancreatic Diversion with Duodenal Switch.

The mechanism of action is assumed to be purely restrictive, but some neurohumoral interaction may exist. Almost no data exist on the influence of the sleeve gastrectomy on the medical and general quality of life or resolution of comorbidities.

The rates of the comorbidities resolution 12 to 24 months after sleeve gastrectomy has been reported in the range that seems to be higher than for the purely restrictive procedures.

Our goal is to to compare the surgical and weight loss outcomes between the two procedures, their influence on resolution of common comorbidities and on quality of life change.

150 eligible candidates will be randomized into two groups, one will undergo Laparoscopic Sleeve Gastrectomy, the other will have Laparoscopic Roux-en-Y Gastric Bypass done. Detailed evaluation and preoperative questionnaires will be used to obtain demographic and medical data, and quality of life will be assessed.

General metabolic and nutritional work up will be done, and will be reassessed at different intervals up to 5 years, in order to compare the short and long term results of the two procedures.


Options:
A: Inclusion Criteria:

* Patient with diagnosis of T2DM for at least 6 months
* Mild to moderate obesity status(BMI 27 - 35 )
* Age : 30 - 60 year-old
* HbA1C \> 8 %

Exclusion Criteria:

* With co-morbidity illness of cardiovascular system
* DM related nephropathy (Cre \>2.0 mg/dl)
* Pulmonary embolism or uncontrolled coagulopathy in 6 months
* HBV or HCV hepatitis or liver cirrhosis, inflammatory colon disease, Cushing syndrome
* s/p organ transplantation
* Previously Bariatric surgery, gastrointestinal surgery, or abdominal sepsis
* Alcoholic or drug abuser
* Psychological disease.
* HIV or TB patient
B: Inclusion Criteria:

* Morbidly obese patients

Exclusion Criteria:

-
C: Inclusion Criteria:

* Adult patients with morbid obesity

Exclusion Criteria:

* Pregnancy,
* Previous bariatric operation,
* IBD,
* Previous bowel or stomach surgery
D: Inclusion Criteria:

* Age \> 18 years and \< 55 years - Male or Female
* BMI \> 35 with significant comorbidities (i.e. hypertension, or hyperlipidemia, or diabetes) or \> 40 BMI \<60 (with or without a co-morbid condition)
* History of failure with nonsurgical weight loss methods
* Candidates for Roux-en-Y gastric bypass
* Patients willing to comply with study requirements
* Patients who have signed an informed consent form

Exclusion Criteria:

* Patients requiring prescription anticoagulation therapy
* Patients with iron deficiency and iron deficiency anemia
* Inflammatory bowel disease or condition of the gastrointestinal tract, such as ulcers or Crohn's disease
* Treatment represents an unreasonable risk to the patient
* Pancreatitis or other serious organic conditions
* Symptomatic coronary artery disease or pulmonary dysfunction
* Patients with known gallstones prior to implant
* Known infection at the time of implant
* Severe coagulopathy, upper gastro-intestinal bleeding conditions such as esophageal or gastric varices, congenital or acquired intestinal telangiectasia
* Congenital or acquired anomalies of the GI tract such as atresias or stenoses
* Pregnant or has the intention of becoming pregnant in the next 12 months
* Unresolved alcohol or drug addiction
* HIV Positive patients
* Patients with hepatitis B or C
* Mentally retarded or emotionally unstable, or exhibits psychological characteristics which, in the opinion of the investigator, makes the subject a poor candidate for device placement or clinical trial
* Previous GI surgery that could affect the ability to place the sleeve or the function of the implant.
* Patients unable to discontinue NSAIDs (non-steroidal anti-inflammatory drugs) during the implant period
* H. pylori positive patients (Note: patients may be enrolled if they had a prior history and were successfully treated)
* Patients receiving weight loss medications such as Meridia and Xenical
* Family or patient history of a known diagnosis or pre-existing symptoms of systemic lupus erythematosus, scleroderma or other autoimmune connective tissue disorder
* Patients with gastroesophageal reflux disease (GERD)
* Patients with a history of kidney stones
* Participating in another ongoing investigational clinical trial

Answer: C