A matched cohort study of laparoscopic biliopancreatic diversion with duodenal switch and sleeve gastrectomy performed by one surgeon

Surg Obes Relat Dis. 2017 Mar;13(3):411-414. doi: 10.1016/j.soard.2016.10.023. Epub 2016 Oct 31.

Abstract

Setting: Spectrum Blodgett and Mercy Health St. Mary's hospitals in Grand Rapids, Michigan OBJECTIVE: To compare the 30-day outcomes of laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) to laparoscopic sleeve gastrectomy (SG).

Background: Laparoscopic BPD/DS has been shown to be superior to SG in terms of excess weight loss. Despite this superiority, BPD/DS accounts for a small percentage of all metabolic surgeries due partly to the perception that BPD/DS has a higher complication rate than SG.

Methods: Retrospective review of all patients who underwent BPD/DS or SG from January 2008 to August 2014 by 1 surgeon was completed. These patients were used to construct cohorts matched via propensity score matching and compared by surgical type. Data collected included patient demographic characteristics; hospital length of stay (LOS); and 30-day rates of leak, bleed, reoperation, readmission, and mortality.

Results: Of the 741 patients who underwent BPD/DS or SG, 2 cohorts of 167 patients each were matched for age, sex, and BMI. LOS was longer in the BPD/DS cohort (2.5±.9 days versus 2.1±.7 days, P<.001). There were no significant differences between the groups in relation to 30-day postoperative rates of leak (.3% versus .6%, P>.99), bleed (0% versus .3%, P>.99), reoperation (1.2% versus .6%, P>.99), or readmission (3% versus 1.2%, P = .45). There were no mortalities.

Conclusion: After matching for age, sex, and BMI, BPD/DS found no significant differences from SG with regard to 30-day postoperative rates of leak, bleed, reoperation, readmission, or mortality.

Keywords: Biliopancreatic diversion; Duodenal switch; Laparoscopic; Sleeve gastrectomy.

MeSH terms

  • Adult
  • Biliopancreatic Diversion / methods*
  • Cohort Studies
  • Duodenum / surgery*
  • Female
  • Gastrectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Obesity, Morbid / surgery
  • Postoperative Hemorrhage
  • Reoperation
  • Retrospective Studies
  • Stents
  • Surgical Wound Dehiscence