Roux-en-Y divided gastric bypass results in the same weight loss as duodenal switch for morbid obesity.
BACKGROUND
The 2 weight loss procedures most commonly performed in the United States are Roux-en-Y gastric bypass (RYGBP) and lateral gastrectomy with duodenal switch (BPD/DS). RYGB is a restrictive procedure, whereas BPD/DS relies on mild restriction of intake as well as malabsorption. Many physicians believe that weight loss is greater after BPD/DS than after RYGBP. However, these procedures have not been compared using groups of patients operated on by the same surgeons at the same institution.


METHODS
We compared weight loss (expressed as percent of excess body weight [%EBW]) after 1 and 2 years in patients who underwent open RYGB or BPD/DS at our institution.


RESULTS
Average length of stay was longer in BPD/DS patients than in those undergoing RYGBP (8.7 vs. 5.9 days, P <0.05). Anastomotic leaks were higher after BPD/DS (6% vs. 3%), but the difference did not achieve statistical significance. Mortality did not differ between the 2 groups (0.8% vs. 0.9%). In the group of patients followed-up for 1 to 2 years, age and distribution of men and women did not differ. Those patients undergoing BPD/DS had higher body mass index (59 vs. 55, P <0.05). Weight loss expressed as %EBW was similar between the 2 groups: 54% versus 53% at 1 year and 67% versus 64% at 2 years.


CONCLUSIONS
Our data suggested that weight loss expressed as %EBW is similar between patients undergoing RYGBP and those undergoing BPD/DS. However, BPD/DS was associated with a longer hospital stay.
Deveney
Clifford W
CW
Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., L223A, Portland, OR 97239, USA. deveneyc@ohsu.edu
MacCabee
David
D
Marlink
Katherine
K
Welker
Kenneth
K
Davis
Justin
J
McConnell
Donald B
DB
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015992:Body Mass Index; D001835:Body Weight; D003920:Diabetes Mellitus / Q000209:etiology; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D015431:Weight Loss