Preliminary results of the duodenal switch.
BACKGROUND
The duodenal switch (DS), as a modification of the bilio-pancreatic diversion (BPD), is a 'complex' hybrid operation.


METHODS
Sixty patients were operated on during the last 3 years.


RESULTS
Two patients died early (3.3%); two late deaths occurred at 4 and 7 months, one due to liver failure and the other due to malnutrition and refeeding syndrome (3.57%); three patients required conversions (5.3%). The two early deaths and all the patients who required conversions had a previous vertical banded gastroplasty. Eleven patients had minor liver abnormalities corrected with medications, and one patient had severe diarrhea for more than a year. Eleven female patients have iron deficiency anemia that requires parenteral supplementation. Mean percent excess weight loss was 86% at 2.5 years.


CONCLUSIONS
The DS has been, in our experience, an unsafe operation with unacceptably high operative and postoperative mortality. The conversion rate is acceptable. Weight loss, quality of food intake and life have been excellent. Inadequate follow-up can be dangerous if patients fail to report for regular visits.
Baltasar
A
A
The Surgical Service, Virgen de los Lirios Hospital, Alcoy, Alicante, Spain.
del Rio
J
J
Escrivá
C
C
Arlandis
F
F
Martínez
R
R
Serra
C
C
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods*; D002423:Cause of Death; D003967:Diarrhea / Q000209:etiology; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005502:Food; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications; D008107:Liver Diseases / Q000188:drug therapy / Q000209:etiology; D017093:Liver Failure / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000209:etiology; D011788:Quality of Life; D012086:Reoperation; D012449:Safety; D015431:Weight Loss