Weight loss and effect on co-morbidities in the long-term after duodenal switch and gastric bypass: a population-based cohort study

Skogar, Martin L.; Sundbom, Magnus

doi:10.1016/j.soard.2019.09.077

Cited by 17 publications

(5 citation statements)

References 25 publications

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“…As one of the currently used bariatric procedures, singleanastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) was first established in 2007 by Torres et al based on the principle of biliopancreatic diversion with duodenal switch (BPD/DS) (5). SADI-S and BPD/DS are widely acknowledged as the most effective bariatric procedure for T2DM treatment (6)(7)(8). Compared with BPD/DS, SADI-S is preferred because it not only maintains similar effects in weight loss and remission of metabolic diseases of BPD/DS, but has a lower operative and malnutritional risk given its ability to reduce one anastomosis and lengthen the common channel of intestine.…”

Section: Introductionmentioning

confidence: 99%

Metabolomics analysis of stool in rats with type 2 diabetes mellitus after single-anastomosis duodenal–ileal bypass with sleeve gastrectomy

Wang

et al. 2022

Front. Endocrinol.

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BackgroundSingle-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) is one of the most effective bariatric procedures in the treatment of type 2 diabetes mellitus (T2DM). However, the mechanisms by which SADI-S improves T2DM are not well-known.ObjectiveTo explore the effects of SADI-S on metabolites in the stool of rats with T2DM.MethodsTwenty rats were fed on high-fat diet and administered with a low-dose (30mg/kg) of streptozotocin to establish T2DM models. The rats were then randomly assigned to the SADI-S group (n=10) and sham operation group (n=9). Stool samples were collected from all rats at 8 weeks after surgery and stored at -80 °C. Metabolomics analysis was performed to identify differential metabolites through ultra- performance liquid chromatography-mass spectrometry.ResultsAt 8-week after surgery, rats of the SADI-S group showed significantly decreased fasting blood glucose, glucose tolerance test 2-hour, glycated haemoglobin, and body weight compared with those of the sham group. A total of 245 differential metabolites were identified between the two groups. Among them, 16 metabolites such as branched-chain amino acids (valine), aromatic amino acid (phenylalanine), bile acid (cholic acid, lithocholic acid, and β-muricholic acid), short-chain fatty acid (isobutyric acid), and phospholipid [lysoPE(17:0), lysoPE(20:3) and lysoPS(16:0)] were associated to the T2DM remission after SADI-S.ConclusionSADI-S improves T2DM in rats by regulating phenylalanine biosynthesis, valine, phenylalanine, alanine, glutamate, proline, bile acid, and phospholipid metabolism pathways.

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Section: Introductionmentioning

confidence: 99%

Metabolomics analysis of stool in rats with type 2 diabetes mellitus after single-anastomosis duodenal–ileal bypass with sleeve gastrectomy

Wang

et al. 2022

Front. Endocrinol.

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“…Several studies report more weight loss after DS, but typically without a randomized design or with more heterogeneous populations not exclusively with BMI of 50 or greater. 6 , 7 , 8 , 9 , 11 , 12 , 13 In a retrospective study of 77 406 patients undergoing RYGB and 1540 undergoing DS with initial mean BMI of 48 and 52, respectively, a greater weight loss and more improvements in comorbidities were observed after DS. 5 In a prospective series (initial BMI, ≥50), superior weight loss was reported after DS at 36 months.…”

Section: Discussionmentioning

confidence: 99%

“…Few controlled studies have evaluated Roux-en-Y gastric bypass (RYGB) compared with DS in patients with a BMI of greater than 50, particularly with follow-up beyond 5 years. 3 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 In the ASGARD (Aker and Sahlgrenska Gastric Bypass Randomized vs Duodenal Switch) trial, 14 , 15 patients with initial BMI of 50 to 60 were randomized to either RYGB or DS. The primary study end point was a change in BMI 2 years after surgery, while secondary end points included sustainability of weight loss, effects on comorbidity, metabolic and nutritional outcomes, health-related quality of life, and adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Ten-Year Outcomes Following Roux-en-Y Gastric Bypass vs Duodenal Switch for High Body Mass Index

Salte,

Olbers,

Risstad

et al. 2024

JAMA Netw Open

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ImportanceResults from long-term follow-up after biliopancreatic diversion with duodenal switch (DS) are scarce.ObjectiveTo compare weight loss, health outcomes, and quality of life 10 years or more after Roux-en-Y-gastric bypass (RYGB) and DS surgery in patients with severe obesity—that is, a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 50 to 60.Design, Setting, and ParticipantsThis open-label randomized clinical trial was conducted at 2 academic bariatric centers in Sweden and Norway. Sixty patients with a BMI of 50 to 60 were included from March 1, 2006, to August 31, 2007. Data were analyzed from August 12, 2022, to January 25, 2023.InterventionsLaparoscopic RYGB or laparoscopic DS.Main Outcomes and MeasuresThe main outcome was change in BMI after 10 or more years. Secondary outcomes included anthropometric measures, lipid and glycemic profiles, bone mass density, adverse events, gastrointestinal tract symptoms, and health-related quality of life.ResultsForty-eight of the original 60 patients (80%) were assessed after a median of 12 (range, 9-13) years (mean [SD] age, 48.0 [6.0] years; 35 women [73%]). At follow-up, the mean BMI reductions were 11.0 (95% CI, 8.3-13.7) for RYGB and 20.3 (95% CI, 17.6-23.0) for DS, with a mean between-group difference of 9.3 (95% CI, 5.4-13.1; P &lt; .001). Total weight loss was 20.0% (95% CI, 15.3%-24.7%) for RYGB and 33.9% (95% CI, 27.8%-40.0%) for DS (P = .001). Mean serum lipid levels, except high-density lipoprotein cholesterol and hemoglobin A1c, improved more in the DS group during follow-up. Bone mass was reduced for both groups from 5 to 10 years, with lower bone mass after DS at 10 years. Quality-of-life scores (Obesity-Related Problem Scale and the 36-Item Short Form Health Survey) were comparable across groups at 10 years. The total number of adverse events was higher after DS (135 vs 97 for RYGB; P = .02). More patients in the DS group developed vitamin deficiencies (21 vs 11 for RYGB; P = .008) including 25-hydroxyvitamin D deficiency (19 for DS vs 9 for RYGB; P = .005). Four of 29 patients in the DS group (14%) developed severe protein-caloric malnutrition, of whom 3 (10%) underwent revisional surgery.Conclusions and RelevanceIn this randomized clinical trial, BMI reduction was greater after DS, but RYGB had a better risk profile over 10 years. Biliopancreatic diversion with DS may not be a better surgical strategy than RYGB for patients with a BMI of 50 to 60.Trial RegistrationClinicalTrials.gov Identifier: NCT00327912

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“…Bariatric surgery has been proven to be more effective in the treatment of obesity and obesity-related metabolic disorders when compared with conventional therapy (4)(5)(6). Among the most commonly performed bariatric operations, biliopancreatic diversion with duodenal switch (BPD-DS) is considered to be the most effective procedure in terms of weight loss and comorbidity remission (7)(8)(9). Despite having been used in the treatment of obesity for about 30 years since Marceau et al (10) first described this procedure in 1993, two main criticisms of BPD-DS are only a few bariatric centers with a regular practice of this procedure, and the lack of reports originating from surgeons in non-Western countries.…”

Section: Introductionmentioning

confidence: 99%

First study on the outcomes of biliopancreatic diversion with duodenal switch in Chinese patients with obesity

Wang

Zhang²,

Wang³

et al. 2023

Front. Surg.

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BackgroundBiliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric procedure used in the treatment of obesity and related metabolic disorders. However, to date, the data on BPD-DS among Chinese patients with obesity is completely lacking.ObjectiveThis is the first study to evaluate the safety and efficacy of BPD-DS in the treatment of Chinese patients with obesity.MethodsData from 12 patients undergoing BPD-DS between September 2019 and March 2020 were analyzed retrospectively to evaluate complications, weight loss, comorbidity resolution, and nutritional status.ResultsAll patients completed the 1-year follow-up. There was no conversion to laparotomy or death. Mean operative time was 257.08 ± 29.27 min. The median length of stay was 7 days (ranging from 4–38 days). Complications occurred in three patients. The 1-year body mass index was 25.13 ± 4.71 kg/m2 with a mean excess weight loss of 100.11 ± 33.29% and a mean total weight loss of 43.22 ± 7.71%. Remission was achieved in 100% (7/7 cases) for type 2 diabetes, in 83.3% (10/12 cases) for hypertension, and in 62.5% (5/8 cases) for hyperuricemia. At 1 year after BPD-DS, the prevalence of albumin deficiency was 16.7%, for iron deficiency was 16.7%, and for zinc deficiency was 50%. There were 8.3% of the patients who were anemic. High deficiency rates for vitamins were presented mainly in vitamin A and vitamin E: vitamin A in 58.3% of the patients and vitamin E in 50% of the patients. The prevalence of asymptomatic gallstones increased significantly from 0% preoperatively to 41.7% postoperatively.ConclusionBPD-DS had excellent weight loss and resolution of comorbidities among Chinese patients with obesity. However, high rates of nutritional deficiencies and complications were found after BPD-DS, especially for vitamin A and vitamin E.

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Weight loss and effect on co-morbidities in the long-term after duodenal switch and gastric bypass: a population-based cohort study

Cited by 17 publications

References 25 publications

Metabolomics analysis of stool in rats with type 2 diabetes mellitus after single-anastomosis duodenal–ileal bypass with sleeve gastrectomy

Metabolomics analysis of stool in rats with type 2 diabetes mellitus after single-anastomosis duodenal–ileal bypass with sleeve gastrectomy

Ten-Year Outcomes Following Roux-en-Y Gastric Bypass vs Duodenal Switch for High Body Mass Index

First study on the outcomes of biliopancreatic diversion with duodenal switch in Chinese patients with obesity

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