Experience in biliopancreatic diversion with duodenal switch: results at 2, 5 and 10 years

Maria Sorribas; Anna Casajoana; Lucía Sobrino; Víctor Admella; Javier Osorio; Jordi Pujol-Gebellí

doi:10.1016/j.ciresp.2021.01.008

Experience in biliopancreatic diversion with duodenal switch: results at 2, 5 and 10 years

Cir Esp (Engl Ed). 2021 Feb 13:S0009-739X(21)00030-0. doi: 10.1016/j.ciresp.2021.01.008. Online ahead of print.

[Article in English, Spanish]

Authors

Maria Sorribas¹, Anna Casajoana², Lucía Sobrino¹, Víctor Admella¹, Javier Osorio¹, Jordi Pujol-Gebellí¹

Affiliations

¹ Departamento de Cirugía General y Digestiva, Unidad de Cirugía Bariátrica y Metabólica, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
² Departamento de Cirugía General y Digestiva, Unidad de Cirugía Bariátrica y Metabólica, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: 43373acb@gmail.com.

PMID: 33593597
DOI: 10.1016/j.ciresp.2021.01.008

Abstract

Introduction: Duodenal switch (DS) is considered one of the most effective techniques to achieve weight loss and reduce comorbidities in patients with morbidly obesity.

Material and methods: Descriptive single-center study. 224 patients were analyzed who underwent direct laparoscopic DS in our center. The objective was to describe the results of weight, resolution of comorbidities, nutritional supplementation and postoperative complications at 2, 5 and 10 years.

Results: The mean age of the cohort was 49.3 [23-65] years and the mean weight and BMI were 131.8 [20]kg and 49.8 [5]kg/m². The excess weight lost percentage at 2, 5 and 10 years was 80.6[15]%, 69.3[18]%, 67.4[18]%, respectively. Complete remission of diabetes was evidenced at 2 and 5 years in 35 (85.4%) and 27 (70.4%) patients. In the immediate postoperative period, the complication rate for Clavien-Dindo ≥ III was 15 patients (6.7%) and mortality at 30 and 90 days was 1 (0.4%) and 2 (0.9%) patients. Revisional surgery was performed in 2 patients (0.9%). 80% of the patients required an extra nutritional supplement up to 10 years after surgery.

Conclusions: Direct DS is a safe and effective technique in patients with a BMI between 45 and 55 kg/m². Weight loss is maintained with a low rate of revision surgery. It is a metabolically effective technique that entails the need for a close postoperative follow-up to assess nutritional supplementation.

Keywords: Bariatric Surgery; Biliopancreatic Diversion; Cirugía bariátrica; Cruce duodenal; Derivación biliopancreática; Duodenal Switch; Obesidad; Obesity.