Biliopancreatic diversion with transient gastroplasty and duodenal switch: long-term results of a multicentric study.

Abstract:

BACKGROUND:Over the years, several modifications of the Scopinaro biliopancreatic diversion (BPD) have been proposed. This retrospective study reported the results of 15 years of follow-up after open BPD coupled with a type of transient gastroplasty (TG) and duodenal switch (DS), termed BPD-TG with DS. METHODS:Data were analyzed for 874 patients operated on between January 1993 and May 2010 in 3 different surgical departments. RESULTS:The median preoperative body mass index (BMI) was 52 kg/m² (range, 35-63). Comorbidities present were hypertension (57%), hypercholesterolemia (87%), hypertriglyceridemia (53%), type 2 diabetes (35%), and obstructive sleep apnea syndrome (OSAS; 9%). The mean follow-up was 11.9 ± 3.1 years. The median BMI decreased to 33.9 after 1 year from bariatric surgery, 31.1 after 2-5 years, 30.9 after 5-10 years, and 31.2 kg/m² after 10-15 years. Overall, 67% of diabetic patients were able to stop insulin and 97% were able to stop oral hypoglycemic drugs within 1 year. Blood pressure, triglyceride levels, and cholesterol levels became normal in >96% of patients within 1 year. OSAS was resolved within 8 months in all cases. One year postoperatively, but absent thereafter, we observed severe hypoalbuminemia (serum albumin <3 g/dL) in 1.7% of patients and severe iron-deficiency anemia in 1.9%. Incisional hernias were recorded in 30% and anastomotic ulcers in 2.4% of cases. Mortality was null. CONCLUSION:Our results suggest considering BPD-TG with DS as a viable bariatric operation, with its excellent long-term outcome in terms of weight loss, improvement of obesity-related diseases, and quality of life.

journal_name

Surgery

journal_title

Surgery

authors

Pata G,Crea N,Di Betta E,Bruni O,Vassallo C,Mittempergher F

doi

10.1016/j.surg.2012.06.039

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

413-22

issue

3

eissn

0039-6060

issn

1532-7361

pii

S0039-6060(12)00485-0

journal_volume

153

pub_type

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