Surgeon performing biliopancreatic diversion

Biliopancreatic Diversion with Duodenal Switch is safe and effective in treating obesity in the long term.

Worldwide use of the Biliopancreatic Diversion (BPD) as a bariatric procedure to treat obesity is still limited due to its relative technical difficulty and demanding follow-up. However, BPD achieves better results than other bariatric operations in the long term of 10-15 years. This study extends the long-term results with another 5 years and reports the 20-year outcomes of 2615 patients undergoing open BPD with Duodenal Switch (DS).

Comorbidities are reduced

Weight loss was maintained for the whole 20 years. Furthermore, over 90% of the patients having diabetes prior to surgery were able to discontinue their diabetes treatment. In addition, comorbidities as hypertension, dyslipidemia and metabolic syndrome were all reduced.

Nutritional status

After 20 years, blood levels of vitamin B12, folic acid, vitamin D, iron, ferritin, and albumin were improved or unchanged from before surgery. In only 2% of the patients, nutritional deficiencies were present for calcium, iron and vitamin A, but these are preventable with assiduous monitoring and supplementation.

BPD-DS is safe and effective to treat obesity

The majority of patients were greatly satisfied with their operation over the very long term, considering weight loss, side effects and quality of life. Regarding that surgical morbidity has been greatly reduced over the 20 years and its positive effects on comorbidities, BPD-DS should have a wider application: operative mortality should no longer be a major factor for choosing less effective operations to treat obesity.

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Marceau P., Biron S., Marceau S., Hould F., Lebel S., Lescelleur O., Biertho L., Simard S., Kral J.G. (2015) Long-Term Metabolic Outcomes 5 to 20 Years After Biliopancreatic Diversion. OBES SURG (2015) 25:1584–1593

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