Artificial Intelligence-Based Comparison of Duodenojejunostomy and Sleeve Gastrectomy on Pancreatic Morphology in Zucker Diabetic Fatty Rats
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Abstract
Objective: This study aims to compare the effects of sleeve gastrectomy (SG), duodenojejunostomy (DJOS), and their combination (DJOS + SG) on glucose regulation and pancreatic histomorphology and function in Zucker diabetic fatty (ZDF) rats, using artificial intelligence (AI)–assisted tissue analysis to assess morphological alterations. Methods: Forty-five male ZDF rats were randomized into three surgical groups (SG, DJOS, DJOS + SG). Oral glucose tolerance tests (OGTT) and insulin levels were assessed at 1, 3 and 6 months post-surgery. Pancreatic tissue was analyzed histologically and immunohistochemically for β-cell mass, PCNA and PDX-1 expression. QuPath software enabled AI-based quantification of acinar, adipose, and fibrotic tissue. Results: DJOS and DJOS + SG improved glucose tolerance and increased fasting insulin compared to SG. Both bypass groups demonstrated greater β-cell mass and clustering, elevated PCNA and PDX-1 expression, and more acinar tissue. SG was associated with reduced β-cell presence and increased pancreatic adiposity. Conclusion: Malabsorptive (DJOS) or combination bariatric procedures (DJOS + SG) significantly enhance glycemic control in the rat model. These effects are accompanied by increased β-cell numbers and clustering, as well as enhanced β-cell proliferation and differentiation. Furthermore, acinar glandular tissue is increased, while pancreatic adiposity is reduced following bypass surgery.
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| Authors | Laessle, Claudia |
| Journal | Frontiers in surgery |
| Year | Year not found |
| DOI |
10.3389/fsurg.2026.1755398
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| Keywords | Keywords not found |
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