Long-term 10-year outcomes of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a comparative multicenter cohort study.
Nour El Ghazal, Graziella Galvao Goncalves, Muhammad A Jawad, Michael L Kendrick, Andre F Teixeira, Omar M Ghanem
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引用次数: 0
Abstract
Background: With the recent endorsement of the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) as a modification of the biliopancreatic diversion with duodenal switch (BPD/DS), long-term data regarding their comparison is scarce. This study aimed to compare the 10-year efficacy and safety outcomes of BPD/DS and SADI-S.
Methods: A retrospective review of patients undergoing BPD/DS and SADI-S as primary procedures was conducted at two centers. Outcomes assessed were weight loss, remission of obesity-related medical conditions and early and late complications. Chi-squared tests, t-tests for parametric data and Mann Whitney U tests for nonparametric data, and a linear fixed effects model were used for statistical analysis.
Results: 101 patients underwent BPD/DS and 32 underwent SADI-S between 2008 and 2014. Mean preoperative body mass index (57.5 ± 9.5 kg/m2 in BPD/DS vs 59.9 ± 9.7 kg/m2 in SADI-S, p = 0.208) and age (46.9 ± 11.0 years in BPD/DS vs 43.3 ± 11.3 years in SADI-S, p = 0.102) were comparable between both groups. The mean percentage total weight loss (%TWL) at all time points, the maximum % TWL (45.7 ± 9.6% in BPD/DS vs 47.3 ± 10.1% in SADI-S, p = 0.418), and remission rates of obesity-related medical conditions were similar. The SADI-S group experienced more intraoperative complications (n = 3 vs n = 0 in BPD/DS, p = 0.013) and longer hospital length of stay (4 vs 3 days in BPD/DS, p < 0.001). More nutritional complications were seen after BPD/DS (53.5% vs 15.6% in SADI-S, p < 0.001). Rates of early and late complications were comparable between both cohorts.
Conclusions: Although SADI-S is a relatively newer technique, long-term results seem promising, especially when compared to the traditional DS, which is known to raise safety and nutritional concerns. More long-term comparative studies are needed to contribute to this growing data.
期刊介绍：
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery
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