Biliopancreatic Diversion for Severe Obesity: Long-Term Effectiveness and Nutritional Complications

Ballesteros-Pomar, María D.; Francisco, T. González de; Urioste-Fondo, Ana; González-Herráez, L.; Calleja-Fernández, Alicia; Casariego, Alfonso Vidal; Simó-Fernández, Vicente; Cano-Rodríguez, Isidoro

doi:10.1007/s11695-015-1719-2

Cited by 41 publications

(19 citation statements)

References 27 publications

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“…years%EWL at max. yearsReoperation %Hess, 2005 [43]DS13009210167753.4Scopinaro, 2005 [44]BPD312781024373NRLarrad-Jiminez, 2007 [45]BPD34368106570NRBallesteros-Pomar 2016 [46]BPD29981103464NRBolckmans, 2016 [47]DS15379101139443Camerini, 2016 [48]BPD12065157967NRSethi, 2016 [49]DS1007210566837Pata, 2013 [50]DS8743810–15 years3287830+Topart, 2017 [51]DS8073Jan-00647311Marceau, 2007 [52]DS1323NRJan-002846921+White, 2017 [53]DS170NR10+2361NR…”

Section: Resultsmentioning

confidence: 99%

Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding

et al. 2018

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IntroductionDurability is a key requirement for the broad acceptance of bariatric surgery. We report on durability at and beyond 10 years with a systematic review and meta-analysis of all reports providing data at 10 or more years and a single-centre study of laparoscopic adjustable gastric banding (LAGB) with 20 years of follow-up.MethodsSystematic review with meta-analysis was performed on all eligble reports containing 10 or more years of follow-up data on weight loss after bariatric surgery. In addition, a prospective cohort study of LAGB patients measuring weight loss and reoperation at up to 20 years is presented.ResultsSystematic review identified 57 datasets of which 33 were eligible for meta-analysis. Weighted means of the percentage of excess weight loss (%EWL) were calculated for all papers included in the systematic review. Eighteen reports of gastric bypass showed a weighted mean of 56.7%EWL, 17 reports of LAGB showed 45.9%EWL, 9 reports of biliopancreatic bypass +/− duodenal switch showed 74.1%EWL and 2 reports of sleeve gastrectomy showed 58.3%EWL. Meta-analyses of eligible studies demonstrated comparable results. Reoperations were common in all groups. At a single centre, 8378 LAGB patients were followed for up to 20 years with an overall follow-up rate of 54%. No surgical deaths occurred. Weight loss at 20 years (N = 35) was 30.1 kg, 48.9%EWL and 22.2% total weight loss (%TWL). Reoperation rate was initially high but reduced markedly with improved band and surgical and aftercare techniques.ConclusionAll current procedures are associated with substantial and durable weight loss. More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy. Reoperation is likely to remain common across all procedures.

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Section: Resultsmentioning

confidence: 99%

Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding

et al. 2018

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“…The bowel surgery of the BPD is easier in the SO patient than the infra diaphragmatic of the SFG. Spanish surgeons made signifi cant contributions on BPD such as Larrad [75,76], Solano [77], Ballesteros [78], Hoyuela [79], on the 90s. Recently Sánchez-Pernaute [80], proposed the now popular LDS of a single anastomosis (SADI).…”

Section: Ds Done By Stagesmentioning

confidence: 99%

A Switch to the Duodenal Switch

Baltasar¹,

Pérez²,

Bou³

et al. 2019

Glob J Obes Diabetes Metab Syndr

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Background: Duodenal Switch (DS) is a procedure that combines a Sleeve-Forming Gastrectomy (SFG) plus a biliopancreatic diversion (BPD) for the treatment of morbid obesity (MO) with a higher weight loss and resolution of comorbidities Objectives: Report our experience with 950 consecutive DS operations performed from 1994 to 2016. Setting: Mix of teaching and private institution in a county hospital of Spain. Methods: We report an observational, retrospective and longitudinal study of 950 consecutive morbidly obese patients treated by DS surgery. Results: We performed 518 open and 432 laparoscopic DS. Operative mortality was 0.84% (1.38% in DS and 0.38% in LDS), 4.84% had leaks, two had hepatic failures (0.2%) and malnutrition was present in 3.1%. At 5 years, the percentage of BMI lost was 80%, and percentage of expected BMI loss was more than 100%. Conclusions: DS is the most aggressive bariatric surgery (BS) technique, but with the best long-term weight loss. We describe operative complications and long-term follow-up guidelines.

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“…En relación a esta variable, cabe decir que la proporción de enfermos que la precisan es del 4,7%, correspondiente a los 5 enfermos mencionados en el párrafo anterior. En el estudio de CD recientemente publicado por Marceau et al (266), la proporción de enfermos que siguen precisando medicación supera en 15 puntos porcentuales nuestra cifra, mientras que los grupos de CB de nuestro entorno próximo (hospitales de Burgos y León) no aportan información sobre esta variable (247,248).…”

Section: 32-modificación Del Metabolismo Lipídicounclassified

“…, 53,3 mg/dl al quinto año, aunque en el grupo del Hospital de León asciende a 58,1 mg/dl al décimo año postoperatorio. El valor de LDL postbariátrico obtenido en nuestra serie es de 72,3 mg/dl, aunque desafortunadamente, ni en los diversos artículos del grupo de N. Scopinaro(237,238,241,271), ni en los trabajosde Marceau et al (266) ni deBallesteros-Pomar et al(247), se notifica de forma concreta esta variable. Es comprensible, que la mejora de la hipercolesterolemia acontece por el descenso del LDL, dado que el HDL sufre pequeñas modificaciones tras la DBP, tal y como informan Scopinaro et al(238).…”

unclassified

“…Como ya se puntualizó en la Introducción, el CD parece obtener un mejor perfil para los déficits de micronutrientes que la DBP, teniendo en cuenta que la longitud de asa común es mayor tal y como describieron los autores de la técnica(208,209). Citando de nuevo a Ballesteros-Pomar et al(247), quienes presentaron recientemente resultados de DBP con seguimiento a 10 años, sus cifras de 25-OH vitamina D son similares a las nuestras inmediatamente antes de la intervención (30,1 ng/ml) pero más favorables en el seguimiento a 5 años (28,7 ng/ml), con una prevalencia de hipovitaminosis D del 52,4%, definida con un valor < 20 ng/ml. De este modo, se interpreta que en nuestra serie el déficit de esta vitamina liposoluble es notablemente mayor, a pesar de la adecuada suplementación que se indica en todos los obesos intervenidos, pudiendo estar justificado por las longitudes de asa común.…”

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Análisis de los efectos ponderales y metabólicos en pacientes con obesidad mórbida tratados mediante derivación biliopancreática en el Hospital Universitario Río Hortega

López¹

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Biliopancreatic Diversion for Severe Obesity: Long-Term Effectiveness and Nutritional Complications

Cited by 41 publications

References 27 publications

Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding

Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding

A Switch to the Duodenal Switch

Análisis de los efectos ponderales y metabólicos en pacientes con obesidad mórbida tratados mediante derivación biliopancreática en el Hospital Universitario Río Hortega

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