Surgery for Obesity and Related Diseases
Volume 6, Issue 1 , Pages 59-63 , January 2010

Should biliopancreatic diversion with duodenal switch be done as single-stage procedure in patients with BMI ≥50 kg/m2?

  • Philippe Topart, M.D.

      Affiliations

    • Société de Chirurgie Viscérale, Clinique de l'Anjou, Angers, France
    • Corresponding Author InformationReprint requests: Philippe Topart, MD, Société de Chirurgie Viscérale, Clinique de l'Anjou, 87, rue du chateau d'Orgemont, Angers 49044 Cedex 01 France
    • ,
  • Guillaume Becouarn, M.D.

      Affiliations

    • Société de Chirurgie Viscérale, Clinique de l'Anjou, Angers, France
    • ,
  • Patrick Ritz, M.D., Ph.D.

      Affiliations

    • Unité Transversale de Nutrition Clinique, Hopital de Rangueil, Toulouse, France

Received 9 February 2009 ,Revised 27 March 2009 ,Accepted 28 April 2009.

References 

  1. Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4(Suppl):S109–S184
  2. Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10:514–523
  3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–1737
  4. Ballantyne GH, Svahn J, Capella RF, et al. Predictors of prolonged hospital stay following open and laparoscopic gastric bypass for morbid obesity: body mass index, length of surgery, sleep apnea, asthma and the metabolic syndrome. Obes Surg. 2004;14:1042–1050
  5. DeMaria EJ, Portenier D, Wolfe L. Obesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing gastric bypass. Surg Obes Relat Dis. 2007;3:134–140
  6. Topart P, Becouarn G, Ritz P. Biliopancreatic diversion with duodenal switch or gastric bypass for failed gastric banding: retrospective study from two institutions with preliminary results. Surg Obes Relat Dis. 2007;3:521–525
  7. Parikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic bariatric surgery in super-obese patients (BMI >50) is safe and effective: a review of 332 patients. Obes Surg. 2005;15:858–863
  8. Stephens DJ, Saunders JK, Belsley S, et al. Short-term outcomes for super-super obese (BMI ≥60 kg/m2) patients undergoing weight loss surgery at a high-volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and open tubular gastric bypass. Surg Obes Relat Dis. 2008;4:408–415
  9. Anthone GJ, Lord RVN, DeMeester TR, Crookes PF. The duodenal switch operation for the treatment of morbid obesity. Ann Surg. 2003;238:618–628
  10. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–282
  11. Marceau P, Biron S, Bourque RA, Potvin M, Hould FS, Simard S. Biliopancreatic diversion with a new type of gastrectomy. Obes Surg. 1993;3:29–35
  12. Buchwald H, Kellogg TA, Leslie DB, Ikramuddin S. Duodenal switch operative mortality and morbidity are not impacted by body mass index. Ann Surg. 2008;248:541–548
  13. Di Betta E, Mittempergher F, Nascimbeni R, Salerni B. Outcome of duodenal switch with a transitory vertical gastroplasty, in super-super-obese patients in an 8-year series. Obes Surg. 2008;18:182–186
  14. Fazylov RM, Savel RH, Horovitz JH, et al. Association of super-super-obesity and male gender with elevated mortality in patients undergoing the duodenal switch procedure. Obes Surg. 2005;15:618–623
  15. Kalfarentzos F, Papadoulas S, Skroubis G, Kehagias I, Loukidi A, Mead N. Prospective evaluation of biliopancreatic diversion with Roux-en-Y gastric bypass in the super obese. J Gastrointest Surg. 2004;8:479–488
  16. Prachand VN, Davee RT, Alverdy JC. Duodenal switch provides superior weight loss in the super-obese (BMI > or = 50 kg/m2) compared with gastric bypass. Ann Surg. 2006;244:611–619
  17. Smith DC, McCormick E, McLean L, Wood S. Laparoscopic biliopancreatic diversion with duodenal switch in patients with BMI >60. Surg Obes Relat Dis. 2005;1:253–254
  18. Spyropoulos C, Bakellas G, Skroubis G, et al. A prospective evaluation of a variant of biliopancreatic diversion with Roux-en-Y reconstruction in mega-obese patients (BMI > or = 70 kg/m(2)). Obes Surg. 2008;18:803–809
  19. Artuso D, Wayne M, Kaul A, Bairamian M, Teixeira J, Cerabona T. Extremely high body mass index is not a contraindication to laparoscopic gastric bypass. Obes Surg. 2004;14:750–754
  20. Oliak D, Ballantyne GH, Davies RJ, Wasielewski A, Schmidt HJ. Short-term results of laparoscopic gastric bypass in patients with BMI > or = 60. Obes Surg. 2002;12:643–647
  21. Raftopoulos I, Ercole J, Udekwu AO, Luketich JD, Courcoulas AP. Outcomes of Roux-en-Y gastric bypass stratified by a body mass index of 70 kg/m2: a comparative analysis of 825 procedures. J Gastrointest Surg. 2005;9:44–52
  22. Sánchez-Santos R, Vilarrasa N, Pujol J, et al. Is Roux-en-Y gastric bypass adequate in the super-obese?. Obes Surg. 2006;16:478–483
  23. Nguyen NT, Rivers R, Wolfe BM. Factors associated with operative outcomes in laparoscopic gastric bypass. J Am Coll Surg. 2003;197:548–555
  24. Fernandez AZ, Demaria EJ, Tichansky DS, et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg. 2004;239:698–702
  25. Flum DR, Salem L, Elrod JA, Dellinger EP, Cheadle A, Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294:1903–1908
  26. Nguyen NT, Longoria M, Gelfand DV, Sabio A, Wilson SE. Staged laparoscopic Roux-en-Y: a novel two-stage bariatric operation as an alternative in the super-obese with massively enlarged liver. Obes Surg. 2005;15:1077–1081
  27. Keidar A, Begleibter N, Chalaila A, Elazary R, Schweiger C, Rivkind A. Bariatric surgery for high risk patients: first staged laparoscopic biliopancreatic diversion with duodenal switch for severe obesity. Isr Med Assoc J. 2007;9:616–617
  28. Gagner M, Gumbs AA, Milone L, Yung E, Goldenberg L, Pomp A. Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index >60 kg/m(2)). Surg Today. 2008;38:399–403
  29. Silecchia G, Rizzello M, Casella G, Fioriti M, Soricelli E, Basso N. Two-stage laparoscopic biliopancreatic diversion with duodenal switch as treatment of high-risk super-obese patients: analysis of complications. Surg Endosc. 2009;23:1032–1037
  30. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–864

PII: S1550-7289(09)00459-6

doi: 10.1016/j.soard.2009.04.016

Surgery for Obesity and Related Diseases
Volume 6, Issue 1 , Pages 59-63 , January 2010

Article Tools