Metabolic and cardiovascular improvements after biliopancreatic diversion in a severely obese patient.
BACKGROUND
Severe obesity is associated with important morbidity and increased mortality. The successes of lifestyle modifications and drug therapy have been partial and mostly unsustained in reducing obesity and its comorbidities. Bariatric surgery, particularly biliopancreatic diversion with duodenal switch reduces efficiently excess body weight and improves metabolic and cardiovascular functions.


METHODS
A 56-year-old man with severe clinical obesity underwent a biliopancreatic diversion with a duodenal switch after unsuccessful treatment with weight loss pharmacotherapy. He had diabetes, hypertension and sleep apnea syndrome and was on three medications for hypertension and two hypoglycemic agents in addition to > 200 insulin units daily. Eleven months after the surgery, he had lost 40% of his body weight. The lipid profile showed great improvement and the hypertension and diabetes were more easily controlled with no more insulin needed. The pseudonormalized pattern of left ventricular diastolic function improved and ventricular walls showed decreased thickness.


CONCLUSIONS
Biliopancreatic diversion may bring metabolic and cardiovascular benefits in severely obese patients from a cardiovascular perspective.
Woods
Philippe
P
Institut Universitaire de Cardiologie et de Pneumologie, Hôpital Laval, 2725 Chemin Ste-Foy, Quebec, Qc, G1V 4G5, Canada. woodsphilippe@hotmail.com
Paquette
Carmen
C
Martin
Julie
J
Dumesnil
Jean-Gaston
JG
Marceau
Picard
P
Marceau
Simon
S
Biron
Simon
S
Hould
Frédéric
F
Lescelleur
Odette
O
Lebel
Stéphane
S
Poirier
Paul
P