title: Biliopancreatic Diversion with Duodenal Switch in the Elderly: Long-Term Results of a Matched-Control Study.
abstract: BACKGROUND
  Biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective surgical approaches for the treatment of severe obesity.
  
  
  OBJECTIVE
  The objective of this study is to compare perioperative complications and long-term results of open BPD-DS in elderly versus younger patients.
  
  
  METHODS
  All patients aged 60 years and above who underwent a primary open BPD-DS in our center were selected (n = 105). Patients were matched 1:1 for sex, BMI, the presence of type 2 diabetes (T2DM), and year of surgery with a group of younger patients (aged ≤55 years).
  
  
  RESULTS
  The mean age of the patients was 62.3 ± 2.0 vs. 40.4 ± 7.0 years (p ≤ 0.0001). Initial BMI and prevalence of T2DM were similar in both groups, at 50.9 kg/m(2) and 57%, respectively. Mean operative time (178.6 ± 46.7 vs. 162.5 ± 39.9 min, p = 0.01), hospital stay (10.2 ± 8.3 vs. 6.3 ± 1.5 days, p = 0.0001), and blood loss (593 ± 484 vs. 474 ± 241 ml, p = 0.05) were significantly higher in elderly patients. No difference in 30-day mortality rate was observed (0.9% in each group). There was no significant difference in major complication rate (16.2 vs. 8.6%, p = 0.09). At a mean follow-up of 7.1 ± 4.1 years, excess weight loss (67.6 ± 19.2 vs. 72.7 ± 20.7%, p = 0.06) and BMI (32.2 ± 5.7 vs. 30.8 ± 6.6 kg/m(2), p = 0.15) were not significantly different. No significant difference was observed between the two groups for the resolution of T2DM (p = 0.53) and obstructive sleep apnea (p = 0.44).
  
  
  CONCLUSIONS
  Open BPD-DS is associated with similar long-term benefits in elderly and younger patients, in terms of weight loss and resolution or improvement of obesity-related comorbidities. Perioperative complications might be more frequent in the elderly population, but this was not associated with increased mortality.
authors.affiliation: Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Canada.|School of Nutrition, Laval University, Québec City, Canada.
authors.forename: Andréanne
authors.initials: A
authors.lastname: Michaud
authors.affiliation: Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Canada.|School of Nutrition, Laval University, Québec City, Canada.
authors.forename: Geneviève B
authors.initials: GB
authors.lastname: Marchand
authors.affiliation: Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Nadeau
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada.
authors.forename: Stéfane
authors.initials: S
authors.lastname: Lebel
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada.
authors.forename: Frédéric-Simon
authors.initials: FS
authors.lastname: Hould
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Marceau
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada.
authors.forename: Odette
authors.initials: O
authors.lastname: Lescelleur
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Biron
authors.affiliation: Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Canada.|School of Nutrition, Laval University, Québec City, Canada.
authors.forename: André
authors.initials: A
authors.lastname: Tchernof
authors.affiliation: Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada. laurentbiertho@gmail.com.
authors.forename: Laurent
authors.initials: L
authors.lastname: Biertho
mesh_terms: D000328:Adult; D000367:Age Factors; D000714:Anastomosis, Surgical; D015904:Biliopancreatic Diversion; D016022:Case-Control Studies; D015897:Comorbidity; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D015995:Prevalence; D015431:Weight Loss
keywords: Bariatric surgery; Biliopancreatic diversion; Duodenal switch; Elderly; Long-term results