Document Detail


A clinical and nutritional comparison of biliopancreatic diversion with and without duodenal switch.
MedLine Citation:
PMID:  15213618     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare biliopancreatic diversion (BPD) without duodenal switch (DS) and with duodenal switch (BPDDS).
BACKGROUND: A reduction of 70% of excess body weight can be achieved after BPD, but there is a risk of malnutrition and diarrhea. This risk may be reduced by pyloric preservation with BPDDS.
METHODS: BPD was performed until 1999, when BPDDS was introduced, both with a common channel of 50 cm. At their latest clinic visit, patients filled in a questionnaire regarding weight loss, dietary history, gastrointestinal symptoms, obesity-related comorbidity, and medication including dietary supplements and underwent a serum nutritional screen.
RESULTS: BPD was performed in 73 patients and BPDDS in 61 patients, with a median preoperative body mass index (BMI) of 44.8 kg/m and a median follow-up of 28 months. There were no significant differences between BPD and BPDDS with regards to age, sex, BMI, or morbidity. Median excess weight loss and BMI at 12, 24, and 36 months was 64.1, 71.0, and 72.1% and 33.1, 31.5, and 31.5 kg/m, respectively; there were no significant differences between BPD and BPDDS. There were no significant differences between BPD and BPDDS with regards to meal size, fat score, nausea, vomiting, diarrhea, or nutritional parameters. However, 18% of patients were hypoalbuminemic, 32% anemic, 25% hypocalcemic, and almost half had low vitamin A, D, and K levels, despite more than 80% taking vitamin supplementation.
CONCLUSION: DS does not improve weight loss or lessen the gastrointestinal or nutritional side effects of BPD.
Authors:
Kevin Dolan; Michael Hatzifotis; Leyanne Newbury; Nadine Lowe; George Fielding
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  240     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-23     Completed Date:  2004-07-22     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  51-6     Citation Subset:  AIM; IM    
Affiliation:
Department Of Surgery, Royal Brisbane Hospital, Queensland, Australia. medkd@iprimus.com.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biliopancreatic Diversion / adverse effects,  methods*
Body Mass Index
Diarrhea / etiology
Dietary Fats / administration & dosage
Dietary Supplements
Duodenum / surgery*
Female
Humans
Male
Middle Aged
Nausea / etiology
Nutritional Status*
Obesity, Morbid / surgery*
Vitamins / administration & dosage
Vomiting / etiology
Weight Loss
Chemical
Reg. No./Substance:
0/Dietary Fats; 0/Vitamins
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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