Current Outcomes of Laparoscopic Duodenal Switch
نویسندگان
چکیده
BACKGROUND Biliopancreatic diversion with duodenal switch (BPD-DS) has long been considered as the bariatric procedure with the highest peri-operative and long-term complication rate. However, modern peri-operative care, including laparoscopic and staged-approach, has significantly reduced the complication rate related to this procedure. The goal of this article is to provide an overview of the current outcomes of laparoscopic BPD-DS in a high volume centre. METHODS All patients who had a laparoscopic BPD-DS with a hand-sewn anastomosis performed between 2011 and 2015 (N = 566) were reviewed. Data were obtained from our prospectively maintained electronic database and are reported as a Mean ± standard deviation. RESULTS The mean age of the 566 patients was 41 ± 10 years, with 78 % women. Initial body mass index was 49 ± 6 kg/m(2). There was no 90-days mortality. Hospital stay was 4.5 ± 3 days. Major 30-days complications occurred in 3.0 % (n = 17) of the patients and minor complications in 2.5 % (N = 14). Excess weight loss was 81 ± 14 % at 12 m, 88 ± 13 % at 24 m, 83 ± 14 % at 36 months. Total body weight loss (kg) was 57 ± 13 kg at 12 months, 63 ± 14 kg at 24 months and 61 ± 17 kg at 36 months. Hemoglobin A1C (HbA1C) dropped from 6.1 ± 1 % to 4.7 ± 0.5 % (p < 0.005) and the percentage of patients with an HbA1C above 6 % decreased from 38 to 1.4 % (p < 0.005). Over 21 ± 12 months follow-up, readmission was required in 3.5 % and reoperation in 0.5 % of the patients. CONCLUSION The current short and medium-term complication rate of laparoscopic BPD-DS are similar to other mixed bariatric procedures with excellent metabolic outcomes.
منابع مشابه
Laparoscopic biliopancreatic diversion with duodenal switch: technique and initial experience.
BACKGROUND The duodenal Switch (DS) is a variant of the biliopancreatic diversion (BPD) for the surgical treatment of morbid obesity. MATERIALS AND METHODS The laparoscopic DS (LapDS) operation is described, and the early surgical outcomes of 16 patients are reported. RESULTS Postoperative stay was 5 to 8 days. Local wound infection at a trocar site was the most common local complication. ...
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