The Impact of Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Over 9 Years.
There is limited information on the multiple long-term effects of the biliopancreatic diversion with duodenal switch (BPD/DS).



Patients who consented to a BPD/DS from 1999 to 2010 were evaluated for weight change, complications, comorbidity resolution, body composition, quality of life, and depressive symptoms during visits at 1, 3,5, 7, and 9 years. Descriptive statistics, analysis of variance, and pair-wise comparisons were calculated for each of the five follow-up cohorts vs. the baseline cohort.



Between 1999 and 2010, 284 patients received a BPD/DS; 275 patients (69.8 % women) age 42.7 years, BMI 53.4 kg/m2qualified for baseline analysis. Two hundred seventy-five patients were available in year 1; 275 patients in year 3; 273 patients in year 5; 259 patients in year 7; and 228 patients in year 9. Gender distribution was not different. BMI was 30.1 at 1 year and 32.0 at 9 years. Body fat was reduced to 26 % after 2 years. Complications requiring surgery were significant. Nutritional problems developed in 29.8 % of patients over the course of observation. The baseline Beck Depression Index (BDI) was 13.9 and 7.2 in year 1. Year 1 through 9 remained unchanged. There were significant positive changes in quality of life between baseline and year 1 for most domains. These positive changes were maintained for the follow-up cohorts. After surgery the resolution of comorbidities continued for the 9 years.



Weight loss during the first year was well maintained, resolving comorbidities and improving quality of life. Rates of surgical complications resemble other bariatric procedures. Long-term nutrient deficiencies are of concern.
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA. gls2010@med.cornell.edu.
Gladys W
GW
Strain
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Mehyar H
MH
Torghabeh
Department of Surgery, Hopital du Sacre Coeur, Montreal, QC, Canada.
Michel
M
Gagner
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Faith
F
Ebel
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Gregory F
GF
Dakin
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Jonathan S
JS
Abelson
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Daniel
D
Connolly
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Alfons
A
Pomp
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods*; D001823:Body Composition; D015992:Body Mass Index; D015897:Comorbidity; D003863:Depression / Q000209:etiology; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
Bariatric surgery complications; Biliopancreatic diversion with the duodenal switch; Body composition after surgical weight loss; Obesity surgery; Quality of life after bariatric surgery
Nutr Clin Pract. 2014 Dec;29(6):718-39
25288251
Obesity (Silver Spring). 2008 Aug;16(8):1953-6
18551107
JAMA Surg. 2015 Apr;150(4):352-61
25650964
Surg Obes Relat Dis. 2013 Jul-Aug;9(4):514-9
23747313
Obes Surg. 2013 Apr;23(4):427-36
23338049
Br J Surg. 2010 Feb;97(2):160-6
20035530
Nutr Diabetes. 2014 Sep 01;4:e132
25177912
Surg Obes Relat Dis. 2016 Nov;12 (9):1697-1705
27425842
Gastroenterol Res Pract. 2013;2013:974762
24639868
Surg Obes Relat Dis. 2015 Jul-Aug;11(4):965-72
25726366
JAMA Surg. 2014 Mar;149(3):275-87
24352617
Surg Endosc. 2009 May;23(5):930-49
19125308
Obes Res. 2005 May;13(5):845-54
15919837
Surg Obes Relat Dis. 2012 Sep-Oct;8(5):542-7
22398110
Surg Obes Relat Dis. 2009 Sep-Oct;5(5):582-7
19560983
Arch Gen Psychiatry. 1961 Jun;4:561-71
13688369
Obes Surg. 2011 Feb;21(2):139-45
21116732
Obes Surg. 2005 Mar;15(3):408-16
15826478
Obes Res. 2001 Feb;9(2):102-11
11316344
Obes Surg. 2014 Sep;24(9):1476-80
24464546
JAMA. 2004 Oct 13;292(14):1724-37
15479938
Surg Obes Relat Dis. 2007 Sep-Oct;3(5):549-53
17903779
Qual Life Res. 2002 Mar;11(2):157-71
12018739
Int J Body Compos Res. 2010;8(2):45-50
21318088
Surg Obes Relat Dis. 2011 Mar-Apr;7(2):199-205
21237723
Obes Surg. 2000 Dec;10(6):514-23; discussion 524
11175958
Obes Surg. 2015 Sep;25(9):1584-93
25676155