Duodenal switch improved standard biliopancreatic diversion: a retrospective study |
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| Authors: | Picard Marceau Simon Biron Frédéric-Simon Hould Stéfane Lebel Simon Marceau Odette Lescelleur Laurent Biertho Serge Simard |
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| Affiliation: | 1. Department of Surgery, Laval University, Laval Hospital, Québec, Québec, Canada;2. Department of Biostatistics, Laval Hospital Research Center, Québec, Québec, Canada;1. AP-HP, Department of Digestive, Oncologic and Metabolic Surgery, Hôpital Ambroise Paré, Boulogne-Billancourt, France;2. UVSQ, UFR des sciences de la santé Simone Veil, 78180, Montigny-le-Bretonneux, France;3. Department of Digestive and Bariatric Surgery, Centre Hospitalier Intercommunal de Créteil, Créteil, France;4. AP-HP, Department of Nutrition, Hôpital Ambroise Paré, Boulogne -Billancourt, France;5. INSERM UMS 011, Villejuif, France;1. Department of Surgery; University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey;2. Rutgers School of Public Health, Piscataway, New Jersey;1. Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;2. Section for Upper Gastrointestinal Surgery, Department of General Surgery, South Hospital, Stockholm, Sweden;3. Colorectal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;4. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom;5. Section of Gastrointestinal Cancer, Division of Cancer Studies, King’s College London, United Kingdom;1. Department of Medicine, University of Padova, Padova, Italy;2. Department of Surgery, Regional Hospital of Vicenza, Vicenza, Italy;1. Department of Surgery, Institute for Bariatric and Metabolic Surgery, Abington Memorial Hospital, Abington, Pennsylvania;2. Department of Medicine, Abington Memorial Hospital, Abington, Pennsylvania |
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| Abstract: | BackgroundThis was a retrospective study, performed 10 years after surgery, to compare the results between biliopancreatic diversion (BPD) with distal gastrectomy (DG) versus BPD with duodenal switch (DS).MethodsComplete follow-up data were available for 96% of patients, allowing a comparison of weight loss, revision, side effects, and complications at 10 years.ResultsAfter BPD-DS, weight loss was 25% greater than after BPD-DG (46.8 ± 21.7 kg versus 37.5 ± 22 kg, respectively; P <.0001). The need for revision decreased from 18.5% to 2.7% (P <.0001), and the prevalence of vomiting during the previous month was 50% less (23.7–50.6%, P <.0001) after BPD-DS compared with after BPD-DG. Late complications were the same for both procedures. Blood analysis showed that, after BPD-DS, the levels of calcium, iron, and hemoglobin were significantly greater and the parathyroid hormone level was lower than after BPD-DG (71.3 ± 44.2 versus 103.0 ± 64.0 ng/L, respectively; P <.0001).ConclusionThe DS greatly improved the BPD, as it was initially proposed. The use of the DS increased weight loss, decreased the need for revision, resulted in fewer side effects, and improved the absorption of nutrients. |
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