Early clinical and surgical results of biliopancreatic diversion.
BACKGROUND
Scopinaro biliopancreatic diversion (BPD) for morbid obesity results in significant longterm weight loss and reduction or resolution of obesity-associated co-morbidities. The aim of our work was to describe the early results after BPD.


METHODS
59 morbidly obese patients (BMI >40) underwent open BPD from December 2001 to December 2004. We analyzed a consecutive series of 19 patients who have been followed >4 months. We present the data of basal and early visits (2 and 4 months).


RESULTS
Initial excess weight percent loss (IEW%L) was 5.2% at 2 months and 13.7% at 4 months. Glycemia, cholesterol, triglyceride levels and blood pressure improved at each visit. All parameters have significant differences from the basal values. 3 patients had sleep apnea syndrome, and overnight CPAP was able to cease in 2 patients by 4 months. 6 patients (31.5%) had albumin <2.5 g/dl, without clinical findings of malnutrition. Total calorie (857+/-79.8 cal/day) and protein (59.8+/-23 g/day) intakes at 4 months were low, with a low intake of multivitamins and oligoelements from food. There was no mortality in this series. Early postoperative morbidity was incisional hernia (21.1%), anastomotic leak (5.2%), wound infection (15.7%), intra-abdominal infection (5.2%), and intestinal obstruction (5.2%).


CONCLUSIONS
BPD showed early effectiveness in weight loss and co-morbidity improvement. Calorie, protein, oligoelement and vitamin dietary intakes were below recommendations, so that strict multidisciplinary follow-up and supplementation to prevent or treat nutritional deficiencies are mandatory.
de Luis
D A
DA
Institute of Endocrinology and Nutrition, Medical School Unit of Investigation, Surgical Department, Hospital Rio Hortega, University of Valladolid, 47130 Valladolid, Spain. dadluis@yahoo.es
Pacheco
D
D
Izaola
O
O
Romero
A
A
Marcos
J L
JL
Pelaz
J
J
Barrera
A
A
Cabezas
G
G
Terroba
M C
MC
Cuellar
L
L
Anta
A
A
D000328:Adult; D015904:Biliopancreatic Diversion / Q000009:adverse effects; D015897:Comorbidity; D003677:Deficiency Diseases / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome