title: Comparison of vertical sleeve gastrectomy versus biliopancreatic diversion.
abstract: BACKGROUND
  Vertical sleeve gastrectomy (VSG) was originally performed as the first-stage of biliopancreatic diversion with duodenal switch (BPD/DS) for superobesity as a strategy to reduce perioperative complications and morbidity. VSG is now considered a definitive procedure because of its technical simplicity and promising outcomes.
  
  
  OBJECTIVE
  To analyze the outcomes of laparoscopic VSG and to compare them with those of single-stage laparoscopic BPD/DS.
  
  
  METHODS
  A retrospective review of 200 consecutive patients who underwent VSG and BPD/DS between 2008 and 2011.
  
  
  RESULTS
  A total of 100 patients underwent laparoscopic VSG and 100 patients underwent laparoscopic BPD/DS. The patients in VSG group were older, but gender distribution and body mass index were comparable. Mean operative time for VSG was significantly shorter compared with that of BPD/DS. A single patient in each groups required open conversion. Staple line leak (n = 1) and intraluminal hemorrhage into the newly-created sleeve (n = 1) occurred in the BPD/DS group. Mean length of stay was shorter after VSG (3.1 vs. 3.9 days). At 6 months postoperatively, excess weight loss between the two groups revealed statistically significant difference, favoring BPD/DS.
  
  
  CONCLUSIONS
  Despite promising outcomes and technical simplicity of VSG, BPD/DS provides significantly superior excess weight loss in morbidly obese patients.
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.
authors.forename: Iswanto
authors.initials: I
authors.lastname: Sucandy
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Titano
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bonanni
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.
authors.forename: Gintaras
authors.initials: G
authors.lastname: Antanavicius
keywords: Biliopancreatic diversion; biliopancreatic diversion; comparison; sleeve gastrectomy