title: The biliopancreatic diversion. A comparison of laparoscopic and laparotomic techniques.
abstract: OBJECTIVE
  Morbid obesity has increased its frequency in the last 20 years in association with the increase of a country's richness. Bariatric surgery has developed a role which is becoming more and more important. The aim of this study, after 10 years of experience with the biliopancreatic diversion, is to compare the laparoscopic versus open technique
  
  
  RESULTS
  
  
  
  METHODS
  From March 1993 to December 2004, 150 patients were operated by biliopancreatic diversion. We divided our experience into 2 groups: laparotomic and laparoscopic techniques. We compared the following variables in the 2 groups: total operating time, intestinal functions, postoperative pain, patient's discharge and recovery time, major postoperative complications, postoperative mortality, late complications, incisional hernia incidence and anastomotic ulceration.
  
  
  RESULTS
  We found a significant difference in both the reduction of the postoperative pain and the recanalization time in the laparoscopic group. Equally, we found a reduction in the incidence of abdominal wall complications, especially the reduction of incisional hernia and infections. The mean operative time was longer in the laparoscopic group, in particular due to the hard learning curve.
  
  
  CONCLUSIONS
  The laparoscopic biliopancreatic diversion is a feasible and safe operation with good results: less postoperative discomfort, shorter recanalization and ospedalization time, less incidence of abdominal wall morbidity (incisional hernia). However, the procedure may prove difficult and it needs a highly experienced surgeon in laparoscopic technique.
authors.affiliation: Unità Operativa di Chirurgia Vascolare Mininvasiva e Robotica, Ospedale S. Matteo degli Infermi, Spoleto (PG), Italy.
authors.forename: M
authors.initials: M
authors.lastname: Stefanoni
authors.forename: L
authors.initials: L
authors.lastname: Casciola
authors.forename: G
authors.initials: G
authors.lastname: Ceccarelli
authors.forename: A
authors.initials: A
authors.lastname: Spaziani
authors.forename: D
authors.initials: D
authors.lastname: Conti
authors.forename: A
authors.initials: A
authors.lastname: Bartoli
authors.forename: L
authors.initials: L
authors.lastname: Di Zitti
authors.forename: R
authors.initials: R
authors.lastname: Bellocchi
authors.forename: R
authors.initials: R
authors.lastname: Valeri