Biliopancreatic diversion with duodenal switch combined with laparoscopic adjustable gastric banding.
BACKGROUND
The authors investigated the usefulness of an approach combining biliopancreatic diversion (BPD) with duodenal switch (DS) and laparoscopic adjustable gastric banding (LAGB) in morbidly obese patients.


METHODS
258 morbidly obese patients underwent bariatric surgery. 80 underwent gastric bypass (GBP), with an 80-ml pouch, a 120-150-cm common channel and a 350-cm alimentary limb (Group 1). 178 underwent BPD combined with DS-LAGB (Group 2): an 80 cm common channel and a 200-cm alimentary limb were created in 68 patients (Subgroup 2a); a 120-cm common channel and a 300-cm alimentary limb were created in 110 patients (Subgroup 2b). Quality of life was assessed using the Moorehead-Ardelt Quality of Life Questionnaire (MA-QLQ).


RESULTS
At 2 years, mean BMI and %EWL were 27.8 kg/m2 and 77.4 (Group 1), 25.2 kg/m2 and 99.6 (Subgroup 2a), and 27.6 kg/m2 and 79.3 (Subgroup 2b), respectively. 4 GBP patients regained their weight 2 years after surgery. There was 1 death, not related to surgery in Subgroup 2b. Preoperative MA-QLQ scores were similar between groups; at 2 years, MA-QLQ scores were higher in Subgroups 2a and 2b compared to Group 1 (+2.49 and +2.59 vs +0.98, respectively).


CONCLUSIONS
Combination bariatric surgery is a safe, effective and durable weight loss option for the treatment of morbid obesity.
Gabriel
Sotirios G
SG
Obesity Surgery Clinic, Athens Medical Center, Athens, Greece.
Karaindros
Christos A
CA
Papaioannou
Marianna A
MA
Tassioulis
Andreas A
AA
Gabriel
Stratis G
SG
Sigalas
Vassilios I
VI
Giannakakis
Panagiotis P
PP
D000328:Adult; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004386:Duodenum / Q000601:surgery; D005260:Female; D015905:Gastric Balloon; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015431:Weight Loss