title: Does preoperative diabetes mellitus affect weight loss outcome after biliopancreatic diversion with duodenal switch?
abstract: BACKGROUND
  Preoperative type 2 diabetes mellitus (T2 DM) has previously been reported as an independent predictor for suboptimal (≤40%) weight loss after Roux-en-Y gastric bypass in patients with T2 DM compared with patients who do not have T2 DM. This association has not been shown to apply to patients who undergo biliopancreatic diversion with duodenal switch (BPD/DS). BPD/DS is currently the most effective bariatric operation to treat T2 DM.
  
  
  OBJECTIVE
  We designed a study to determine if the reported suboptimal weight loss seen in patients with T2 DM undergoing Roux-en-Y gastric bypass is also seen in those undergoing BDP/DS.
  
  
  METHODS
  Independent, university-affiliated teaching hospital.
  
  
  METHODS
  Retrospective chart review of a prospectively maintained database was performed on data on 152 patients who underwent robotically assisted laparoscopic BPD/DS from 2008 to 2012. Patients were divided into 2 groups: those with a preoperative diagnosis of T2 DM (Group 1, n = 51) versus those without a preoperative diagnosis of T2 DM (Group 2, n = 101). Perioperative complications and postoperative weight loss between the 2 groups were compared.
  
  
  RESULTS
  At 1 month postoperatively, Group 1 had a higher percentage of excess weight loss (%EWL) of 20.9% compared with Group 2 of 17.9% (P<.05). At 3, 6, 9, 12, and 18 months postoperatively, both groups had statistically comparable %EWL (P>.05). Thirty-day perioperative complications were higher in Group 1 compared with those in Group 2 (7.8% and 3.9%, respectively). Reoperation rates were similar in both groups (1.9%). No mortality was recorded in this series.
  
  
  CONCLUSIONS
  Patients with diabetes had a similar weight loss outcome after BPD/DS compared with those who did not have diabetes.
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania. Electronic address: mabulfaraj@yahoo.com.
authors.forename: Moaz
authors.initials: M
authors.lastname: Abulfaraj
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania.
authors.forename: Amarita
authors.initials: A
authors.lastname: Klar
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania.
authors.forename: Iswanto
authors.initials: I
authors.lastname: Sucandy
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania.
authors.forename: Gintaras
authors.initials: G
authors.lastname: Antanavicius
mesh_terms: D000328:Adult; D000368:Aged; D015904:Biliopancreatic Diversion / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
keywords: Bariatric surgery; Biliopancreatic diversion; Diabetes mellitus; Duodenal switch; Weight loss outcomes