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.
Institute of Endocrinology and Nutrition, Medical School Unit of Investigation, Surgical Department, Hospital Rio Hortega, University of Valladolid, 47130 Valladolid, Spain. dadluis@yahoo.es
D A
DA
de Luis
D
D
Pacheco
O
O
Izaola
A
A
Romero
J L
JL
Marcos
J
J
Pelaz
A
A
Barrera
G
G
Cabezas
M C
MC
Terroba
L
L
Cuellar
A
A
Anta
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