Outcome of laparoscopic duodenal switch for morbid obesity.
BACKGROUND
The aim of this study was to determine the safety and efficacy of laparoscopic duodenal switch (LDS) as a treatment option in a selected group of patients with morbid obesity.


METHODS
This retrospective analysis of a prospective database assessed the frequency of all complications and alterations in weight, body mass index (BMI), co-morbidity and quality of life.


RESULTS
One hundred and twenty-one patients underwent LDS between April 2003 and March 2009. Median preoperative weight was 160 kg and median BMI 55 kg/m(2). All procedures were performed laparoscopically. The in-hospital mortality rate was zero. No ileoduodenal anastomotic stenosis was encountered. There were four clinical leaks (3·3 per cent) managed by laparoscopic drainage and placement of a feeding jejunostomy. Median percentage excess weight loss was 75 per cent at 12 months and 90 per cent at 24 months. Thirty-six of 40 diabetic patients had complete resolution of diabetes within 1 year. There were significant improvements in other obesity-related co-morbidity. Only a few patients developed postoperative protein deficiency, and fat-soluble vitamin deficiencies were easily managed with oral supplementation.


CONCLUSIONS
The LDS procedure is a safe and effective treatment for morbid obesity and its associated co-morbidity in selected patients.
Magee
C J
CJ
Gravitas, PO Box 3627, Bourne End SL8 5GQ, UK.
Barry
J
J
Brocklehurst
J
J
Javed
S
S
Macadam
R
R
Kerrigan
D D
DD
D000328:Adult; D000714:Anastomosis, Surgical; D015992:Body Mass Index; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D007081:Ileostomy / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008136:Longevity; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss