Abstract
Background
Gastric bypass (GB) is the most common surgical procedure for weight loss in the United
States. Biliopancreatic diversion with duodenal switch (BPD/DS) is less routinely
performed, perhaps because of its technical difficulty and metabolic concerns. The
objective of this study was to determine whether these procedures had differential
effects on weight loss and body composition.
Methods
Body composition was measured by bioimpedance (Tanita 310) at the initial consultation,
and follow-up measurements were completed 1–2 years after surgery.
Results
Of the 72 patients in the study, 50, aged 46.2 ± 8.5 years, had undergone GB and were
measured 15.5 ± 5.2 months after surgery and 22, aged 40.6 ± 7.9 years, had undergone
BPD/DS and were measured 19.5 ± 7.5 months after surgery. Patient age and time after
surgery were significantly different between the 2 groups. The body mass index (BMI)
for the BPD/DS group was 53.6 ± 11.9 kg/m2, significantly greater than the BMI of the GB group (48.0 ± 6.3 kg/m2; P = .009). However, the percentage of body fat did not differ between the 2 groups
(P = .515). Postoperatively, the BMIs for the GB group (31.5 ± 5.0 kg/m2) and BPD/DS group (30.3 ± 6.1 kg/m2) were not significantly different (P = .384). The percentage of body fat for the GB and BPD/DS groups had changed from
49.2% ± 8.3% to 32.1% ± 10.6% and 47.9% ± 5.9% to 23.8% ± 10.4%, respectively (P = .002). The BMI had decreased by 16.5 ± 4.8 kg/m2after GB and 23.3 ± 6.8 kg/m2 after BPD/DS (P <.001). The decrease in fat was 17.1% ± 8.2% after GB and 24.2% ± 7.2% after BPD/DS
(P <.001).
Conclusion
The BPD/DS procedure is more effective in reducing the BMI and promoting fat loss
than is GB. The assessment of the impact of these two operations on an individualized
basis offers additional information to assist in the evaluation of these procedures.
Keywords
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Article info
Publication history
Published online: November 20, 2006
Accepted:
September 4,
2006
Received in revised form:
August 15,
2006
Received:
June 9,
2006
Identification
Copyright
© 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
