Biliopancreatic diversion with duodenal switch results in superior weight loss and diabetes remission in patients with baseline body mass index ≥50.

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Pub Date : 2024-12-02 DOI:10.1016/j.soard.2024.11.004

Alvin Chang, Luis Pina, Donovan Harris, Craig Wood, Vladan Obradovic, David M Parker

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Abstract

Background: Patients with body mass index (BMI) ≥50 have more obesity-associated medical problems and often require more aggressive surgical management. Few single-institution comparative studies have been published examining this specific population.

Objectives: The study aims to compare the weight loss and diabetes remission effects of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion with duodenal switch (BPD/DS).

Setting: Rural academic tertiary care center.

Methods: We conducted a retrospective cohort study using prospectively collected data. All patients with a BMI ≥50 who underwent an SG, RYGB, and BPD/DS were included. Comparative analysis was performed for complications, readmission rates, weight loss, and diabetes remission.

Results: Excess weight loss at 3 years was 40.1% for SG, 54.1% for RYGB, and 67.4% for BPD/DS, with BPD/DS performing significantly better (P < .001). Complete diabetes remission at 5 years was 29% for SG, 61% for RYGB, and 79% for BPD/DS. BPD/DS had significantly longer operative times (P < .001) and rates of minor complications (P = .02).

Conclusions: BPD/DS achieved superior sustained weight loss and diabetes remission compared with RYGB and SG.

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在基线体重指数≥50的患者中，胆胰转流合并十二指肠转换可显著减轻体重和缓解糖尿病。

背景：体重指数(BMI)≥50的患者有更多与肥胖相关的医学问题，通常需要更积极的手术治疗。很少有针对这一特定人群的单机构比较研究发表。目的：本研究旨在比较袖胃切除术（SG）、Roux-en-Y胃旁路术（RYGB）和十二指肠开关胆胰分流术（BPD/DS）的减肥和糖尿病缓解效果。环境：农村三级学术医疗中心。方法：采用前瞻性收集的资料进行回顾性队列研究。所有BMI≥50的患者均接受了SG、RYGB和BPD/DS。对并发症、再入院率、体重减轻和糖尿病缓解进行比较分析。结果：SG组3年体重减重40.1%，RYGB组减重54.1%，BPD/DS组减重67.4%，其中BPD/DS组减重显著优于rgb组（P < 0.001）。5年糖尿病完全缓解：SG为29%，RYGB为61%，BPD/DS为79%。BPD/DS手术时间明显延长（P < 0.001），轻微并发症发生率显著提高（P = 0.02）。结论：与RYGB和SG相比，BPD/DS获得了更好的持续体重减轻和糖尿病缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

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