Biliopancreatic diversion with transitory gastroplasty preserving duodenal bulb: 3 years experience.
BACKGROUND
The authors have performed 521 bariatric surgery operations (319 restrictive procedures and 202 malabsorptive procedures).


METHODS
During the last few years we have introduced an evolution of biliopancreatic diversion (BPD): BPD with transitory gastroplasty, preserving the duodenal bulb (53 cases). From a technical point of view, the operation consists of a BPD, coupled with a gastroplasty which is transitory due to the use of a polydioxanone (PDS) band. In the last few cases, instead of a VBG (with PDS band) in order to make the operation completely reversible without any suture on the stomach, we made a gastric pouch by banding with PDS calibrated with the same tube as for the Lap-band (20 cc). We maintained completely the duodenal bulb (5 cm from the pylorus), making an end-to-side duodeno-ileal isoperistaltic anastomosis.


RESULTS
With this anastomosis, only 2% of patients developed an anastomotic ulcer. With this new procedure, results have been good in terms of weight loss (similar to that of BPD-AHS) and in nutritional complications. No patient has had hypoalbuminemia, diarrhea or halitosis.


CONCLUSIONS
BPD with temporary gastric restriction has provided satisfactory results.
Vassallo
C
C
Interdisciplinary Centre of Obesity, Surgical Division, Stradella's Hospital, Italy.
Negri
L
L
Della Valle
A
A
Salvaneschi
M
M
Vegezzi
C
C
Griziotti
A
A
Dono
C
C
Mussi
P
P
Bausardo
M G
MG
Pietrobono
P
P
D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods / Q000706:statistics & numerical data; D004386:Duodenum; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss