Scientific Research: Duodenal Switch is HIGHLY efficient in weight loss of NON-Super...

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Is Bliopancreatic Diversion with Duodenal Switch Indicated in Non Super- Obese Patients?

Laurent Biertho, MD; Stefane Lebel, MD; Simon Marceau, MD; Frederic S. Hould, MD; Odette Lescelleur, MD; Simon Biron, MD; Picard Marceau, MD, PhD; Laval University, Laval Hospital, Quebec, QC, Canada

Background:
Biliopancreatic Diversion with Duodenal Switch (BPD-DS) is our standard treatment for morbid obesity since the early 90's.  However, many institutions consider BPD-DS only in super-obese patients, due to the allegedly higher risk of complications and protein malnutrition.  The purpose of this study was to assess the safety and efficacy of BPD-DS in non super-obese patients.

Methods:
All patients with a BMI under 50kg/m2 who underwent the BPD-DS between June 1992 and May 2005 were included in this study (n=810).  Data is reported as a mean (range).

Results:
Pre-operative BMI was 44.2 kg/m2 (33 to 49.9 kg/m2).  Major intra-operative complications occurred in 7 patients (0.9%) (1 liver laceration and 6 splenic injuries.)  Major post-operative complications occured in 26 patients (3.2%).  (5 duodeno-ileal anastomotic leaks, 5 intra-abdominal abcesses, 1 gastric leak, 3 biliary leaks, 1 peritonitis, 3 pneumonia, 3 septic shock, 2 pulmonary embolisms, 1 pancreatitis, 1 severe metabolic acidosis, 1 intra-abdominal hemorrhage.)  There were 5 peri-operative deaths (0.61%) (2 pulmonary embolisms, 1 fulminant pneumonia, 1 spetic shock, 1 metabolic acidosis of unknown origin).  The mean excess weight loss after 8.6 years (3 to 16.7 yeras) was 76%.  91.3% of the patients had a BMI under 35kg/m2 and 70% had a BMI under 30kg/m2.  35 patients (4.3%) were readmitted for malnutrition or metabolic disorders.  Among these, 12 patients (1.5%) required a lengthening of the alimentary limb for excessive weight loss.

Conclusion:
The results of this study suggest that BPD-DS is highly efficient in terms of weight loss in non super-obese patients, with minimal risks of long-term malnutrition.  Peri-operative complication rate compares favorably to other bariatric procedures.

Thanks for X-posting this! YOU ROCK!!! 

This is a great study for people to consider in their surgical weight loss decision-making.

I am SO Thankful that MN Healthpartners just covers the DS for non-super obese and for BMI's below 50.  I am so thankful to have Dr. Buchwald in my backyard!  He is such a skilled and fantastic surgeon. 

Healthpartners rocks.

Dr. Buchwald rocks.

The DS rocks. 

Now, THAT was laden with personal opinion.  :)

Kathy

No opinions allowed, Kathy!  

I have Medica and it only covered DS for BMI over 55.  I was in that category (unfortunately and fortunately) but I hope I would have fought them had I been smaller at the beginning of my WLS journey.

Hey Thanks!

I think HealthPartners is way ahead of the game on the DS approval as an equally approved surgery as RNY or Lap Band and for all obese BMI's.  Somebody is really thinking over there!!  :) 

I know that I am so fortunate.  It is taking too many surgeons and too many insurerers much too long to catch up with the research. 

There are also too many lies about the DS.  That ALL DSers have certain symptoms or certain problems, which if you read the RNY board....   all bariatric patients may have problems, known side-effects, and consequences. 

Conclusion:
The results of this study suggest that BPD-DS is highly efficient in terms of weight loss in non super-obese patients, with minimal risks of long-term malnutrition.  Peri-operative complication rate compares favorably to other bariatric procedures.

The conclusions of the studies speak for the DS. 

:)
Kathy

Hey, Kathy, even BCBS is catching up - slowly, of course, but anything other than the headache some of us had to endure, is way worth it for newbies!

You look fabulous BTW!!!

Hey thank-you, you do as well!

I sure would like to get together with you, and Amanda, and Scrapper, and Mary, and maybe Peach, and others!!  All of us, MN Dser's.  :) 

Yeah Kathy!

Jennifer

:o)
We really all have to get together! 
Kathy