The duodenal switch with vertical gastrectomy for morbid obesity: Effective weight loss and lipid reduction without creation of nutrient deficiency

Summary Biliopancreatic derivation with duodenal switch (BPDDS) as an operative technique in the management of morbid obesity was created as an alternative to BPD (Scopinaro's operation), because of BPD-DS's fewer malabsorption side effects, better restrictive effect to the stomach remnant, fewer peptic ulcers and dumping syndromes, as well as lower morbidity and mortality rate. Between January 2003 and June 2012 in the University Hospital Center of Albacete, 141 patients with morbid obesity underwent BPD-DS. The patients were divided in groups according to four criteria: length of the common channel, age, gender and initial Body Mass Index. On the 6th postoperative year in our study the percent of excessive body weight loss was 67.6% and the percentage of excessive BMI loss was 73%. According to the evaluation announced by Hess D.S. & Hess D.W, our results could be assessed as successful after 6 months, good on the first year, excellent on the second, and good from 3rd to 9th postoperative years. Our results confirm the hypothesis that the biliopancreatic derivation with duodenal switch is a bariatric intervention, which leads to a significant weight loss, well preserved in time.

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Roux-en-Y divided gastric bypass results in the same weight loss as duodenal switch for morbid obesity

The American Journal of Surgery ◽

10.1016/j.amjsurg.2004.01.001 ◽

2004 ◽

Vol 187 (5) ◽

pp. 655-659 ◽

Cited By ~ 29

Author(s):

Clifford W Deveney ◽

David MacCabee ◽

Katherine Marlink ◽

Kenneth Welker ◽

Justin Davis ◽

...

Keyword(s):

Morbid Obesity ◽

Weight Loss ◽

Gastric Bypass ◽

Duodenal Switch

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Influence of common channel length on weight loss after duodenal switch operation for morbid obesity

Gastroenterology ◽

10.1016/s0016-5085(03)84112-4 ◽

2003 ◽

Vol 124 (4) ◽

pp. A815

Author(s):

Reginald V. Lord ◽

Gary J. Anthone ◽

Peter F. Crookes ◽

Nahid Hamoui ◽

Liya Abramyan ◽

...

Keyword(s):

Morbid Obesity ◽

Weight Loss ◽

Duodenal Switch ◽

Channel Length ◽

Common Channel ◽

Switch Operation

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TYPE 2 DIABETES MELLITUS REMISSION AND ITS PREDICTION AFTER TWO-STAGE SURGICAL TREATMENT OF PATIENTS WITH MORBID OBESITY

Wiadomości Lekarskie ◽

10.36740/wlek201905102 ◽

2019 ◽

Vol 72 (5) ◽

pp. 739-743

Author(s):

Oleksandr Yu. Ioffe ◽

Mykola S. Kryvopustov ◽

Yuri A. Dibrova ◽

Yuri P. Tsiura

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Morbid Obesity ◽

Weight Loss ◽

Type 2 Diabetes Mellitus ◽

Surgical Treatment ◽

Two Stage ◽

C Peptide ◽

Peptide Level

Introduction: Morbid obesity (MO) has a significant impact on mortality, health and quality of life of patients. Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with MO. The aim is to study T2DM remission and to develop a prediction model for T2DM remission after two-stage surgical treatment of patients with MO. Materials and methods: The study included 97 patients with MO. The mean BMI was 68.08 (95% CI: 66.45 - 69.71) kg/m2. 70 (72,2%) patients with MO were diagnosed with T2DM. The first stage of treatment for the main group (n=60) included the IGB placement, for the control group (n=37) - conservative therapy. In the second stage of treatment the patients underwent bariatric surgery. The study addresses such indicators as BMI, percentage of weight loss, percentage of excess weight loss, ASA physical status class, fasting glucose level, HbA1c, C-peptide. Results: Two-stage treatment of morbidly obese patients with T2DM promotes complete T2DM remission in 68.1% of patients. The risk prediction model for failure to achieve complete T2DM remission 12 months after LRYGB based on a baseline C-peptide level has a high predictive value, AUC = 0.84 (95% CI: 0.69-0.93), OR = 0.23 ( 95% CI: 0.08-0.67). Conclusions: Two-stage treatment of patients with MO promotes improvement of carbohydrate metabolism indicators. With a C-peptide level > 3.7 ng/ml, prediction of complete T2DM remission 12 months after Laparoscopic Roux-en-Y Gastric Bypass is favorable.

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Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes

Diagnostics ◽

10.3390/diagnostics11040721 ◽

2021 ◽

Vol 11 (4) ◽

pp. 721

Author(s):

Tannaz Jamialahmadi ◽

Mohsen Nematy ◽

Simona Bo ◽

Valentina Ponzo ◽

Ali Jangjoo ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Success Rate ◽

Liver Stiffness ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Post Surgery ◽

Hs Crp

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

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