Laparoscopic biliopancreatic diversion: technique and initial results.
BACKGROUND
Biliopancreatic diversion (BPD) is an efficient method for treating morbid obesity. We present the BPD technique by laparoscopy and the 1st year follow-up.


METHODS
From July 2000 to April 2001, 40 patients underwent laparoscopic BPD (29 women, 11 men), with average age 39 (17-60). Average BMI was 43.6 kg/m2 (38-65). All operations were completed successfuly by laparoscopy. The technique followed strictly the operation of Scopinaro. 7 of these patients had removal of an adjustable gastric band and were converted to BPD. All underwent cholecystectomy.


RESULTS
Mean loss of initial excess weight at 3, 6 and 10 months was approximately 30%, 50% and 90%. Mortality was 2.5% (1 patient) due to massive pulmonary embolism. Average operating time was 210 minutes (130-480), and average hospital stay was 4.3 days (3-21). There were 5 postoperative complications (12.5%): 2 pulmonary emboli, 2 GI bleeding from the staple-line, and 1 fistula. There have been 5 late complications (12.5%): 3 cases of diarrhea, 2 elevated PTH with normal calcium, and hypothyroidism that was difficult to control.


CONCLUSIONS
BPD may be performed by laparoscopy without changes in the original technique or in the early results.
Paiva
Dyker
D
Centro Mineiro de Cirurgia Avançada, Belo Horizonte, MG, Brasil. cmga@e-gerais.com
Bernardes
Lucinéia
L
Suretti
Lívio
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D015904:Biliopancreatic Diversion / Q000009:adverse effects* / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology