title: Duodenal switch improved standard biliopancreatic diversion: a retrospective study.
abstract: BACKGROUND
  This was a retrospective study, performed 10 years after surgery, to compare the results between biliopancreatic diversion (BPD) with distal gastrectomy (DG) versus BPD with duodenal switch (DS).
  
  
  METHODS
  Complete follow-up data were available for 96% of patients, allowing a comparison of weight loss, revision, side effects, and complications at 10 years.
  
  
  RESULTS
  After BPD-DS, weight loss was 25% greater than after BPD-DG (46.8 +/- 21.7 kg versus 37.5 +/- 22 kg, respectively; P <.0001). The need for revision decreased from 18.5% to 2.7% (P <.0001), and the prevalence of vomiting during the previous month was 50% less (23.7-50.6%, P <.0001) after BPD-DS compared with after BPD-DG. Late complications were the same for both procedures. Blood analysis showed that, after BPD-DS, the levels of calcium, iron, and hemoglobin were significantly greater and the parathyroid hormone level was lower than after BPD-DG (71.3 +/- 44.2 versus 103.0 +/- 64.0 ng/L, respectively; P <.0001).
  
  
  CONCLUSIONS
  The DS greatly improved the BPD, as it was initially proposed. The use of the DS increased weight loss, decreased the need for revision, resulted in fewer side effects, and improved the absorption of nutrients.
authors.affiliation: Department of Surgery, Laval University, Laval Hospital, Québec, Québec, Canada. picard.marceau@chg.ulaval.ca
authors.forename: Picard
authors.initials: P
authors.lastname: Marceau
authors.forename: Simon
authors.initials: S
authors.lastname: Biron
authors.forename: Frédéric-Simon
authors.initials: FS
authors.lastname: Hould
authors.forename: Stéfane
authors.initials: S
authors.lastname: Lebel
authors.forename: Simon
authors.initials: S
authors.lastname: Marceau
authors.forename: Odette
authors.initials: O
authors.lastname: Lescelleur
authors.forename: Laurent
authors.initials: L
authors.lastname: Biertho
authors.forename: Serge
authors.initials: S
authors.lastname: Simard
mesh_terms: D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods*; D016009:Chi-Square Distribution; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss