title: A matched cohort study of laparoscopic biliopancreatic diversion with duodenal switch and sleeve gastrectomy performed by one surgeon.
abstract: METHODS
  Spectrum Blodgett and Mercy Health St. Mary's hospitals in Grand Rapids, Michigan OBJECTIVE: To compare the 30-day outcomes of laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) to laparoscopic sleeve gastrectomy (SG).
  
  
  BACKGROUND
  Laparoscopic BPD/DS has been shown to be superior to SG in terms of excess weight loss. Despite this superiority, BPD/DS accounts for a small percentage of all metabolic surgeries due partly to the perception that BPD/DS has a higher complication rate than SG.
  
  
  METHODS
  Retrospective review of all patients who underwent BPD/DS or SG from January 2008 to August 2014 by 1 surgeon was completed. These patients were used to construct cohorts matched via propensity score matching and compared by surgical type. Data collected included patient demographic characteristics; hospital length of stay (LOS); and 30-day rates of leak, bleed, reoperation, readmission, and mortality.
  
  
  RESULTS
  Of the 741 patients who underwent BPD/DS or SG, 2 cohorts of 167 patients each were matched for age, sex, and BMI. LOS was longer in the BPD/DS cohort (2.5±.9 days versus 2.1±.7 days, P<.001). There were no significant differences between the groups in relation to 30-day postoperative rates of leak (.3% versus .6%, P>.99), bleed (0% versus .3%, P>.99), reoperation (1.2% versus .6%, P>.99), or readmission (3% versus 1.2%, P = .45). There were no mortalities.
  
  
  CONCLUSIONS
  After matching for age, sex, and BMI, BPD/DS found no significant differences from SG with regard to 30-day postoperative rates of leak, bleed, reoperation, readmission, or mortality.
authors.affiliation: Michigan State University College of Human Medicine, East Lansing, Michigan. Electronic address: polegaja@msu.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Polega
authors.affiliation: Grand Rapids Medical Education Partners /Michigan State University Family Medicine Residency, East Lansing, Michigan.
authors.forename: Tyler W
authors.initials: TW
authors.lastname: Barreto
authors.affiliation: Grand Health Partners, Grand Rapids, Michigan.
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Kemmeter
authors.affiliation: Grand Rapids Medical Education Partners Research Department, East Lansing, Michigan.
authors.forename: Tracy J
authors.initials: TJ
authors.lastname: Koehler
authors.affiliation: Grand Rapids Medical Education Partners Research Department, East Lansing, Michigan; Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Michigan.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Davis
authors.affiliation: Grand Health Partners, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Michigan.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kemmeter
mesh_terms: D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods*; D015331:Cohort Studies; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D019106:Postoperative Hemorrhage; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013529:Surgical Wound Dehiscence
keywords: Biliopancreatic diversion; Duodenal switch; Laparoscopic; Sleeve gastrectomy