Results of biliopancreatic diversion after five years.
BACKGROUND
Gastric restrictive procedures, currently the most popular surgical operations for morbid obesity, have proved to be effective in initiating weight loss, but questions regarding their long-term efficacy in weight maintenance have arisen. Biliopancreatic diversion (BPD) is a mixed and complex technique that has shown good long-term results. There are no series with long-term follow-up of BPD in Spain. We present >5 year results (average 67.9 +/- 15 SD mons, range 48-96), evaluating weight loss, morbidity and mortality after BPD.


METHODS
74 patients who underwent BPD and completed 5 or more years of follow-up were studied. The results have been analyzed in terms of weight loss (classification of Reinhold), improvement in morbidity, and improvement in quality of life (BAROS).


RESULTS
78.6% were women. Mean age was 38 +/- 11 years (18-61). Mean preoperative body mass index (BMI) was 54 +/- 8 kg/m(2). Progression of BMI: 1 year 34 +/- 6, 2 years 31 +/- 6, 5 years 33 +/- 7 and 7 years 31 +/- 3 kg/m(2). Excess weight loss at 1 year follow-up was 67%, at 2 years 75%, at 5 years 70% and at 7 years 71%. There were significant differences between morbidly obese (BMI <50 kg/m(2)) and super-obese (BMI >50 kg/m(2) ), with better results in the morbidly obese group.


CONCLUSIONS
BPD shows long-term effectiveness in weight loss, co-morbidity improvement and quality of life. Protein, vitamin and oligoelement deficits may appear in the long-term, so that strict follow-up and supplementation of deficiencies are necessary.
Department of Surgery, Clínico Universitario Lozano Blesa, San Juan Bosco, 5006 Zaragoza, Spain.
Manuela Elía
ME
Guedea
Dolores
D
Arribas del Amo
Jose Antonio Gracia
JA
Solanas
Consuelo Artigas
CA
Marco
Alfredo Jiménez
AJ
Bernadó
Miguel Angel Bielsa
MA
Rodrigo
Vicente Aguilella
VA
Diago
Mariano Martínez
MM
Díez
D000293:Adolescent; D000328:Adult; D015904:Biliopancreatic Diversion / Q000009:adverse effects; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss
D001786:Blood Glucose; D008055:Lipids