Outcomes of Duodenal Switch with a Moderate Common Channel Length and Roux-en-y Gastric Bypass: Does One Pose More Risk?
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ORIGINAL CONTRIBUTIONS
Outcomes of Duodenal Switch with a Moderate Common Channel Length and Roux-en-y Gastric Bypass: Does One Pose More Risk? Alaa Sada 1,2 & Rolando D. Calderon-Rojas 1 & Thomas Szabo Yamashita 1 & Wendy S. Reidt 3 & Amy E. Glasgow 2 & Michael L. Kendrick 1 & Maria L. Collazo-Clavell 4 & Elizabeth B. Habermann 2,3 & Travis J. McKenzie 1 & Todd A. Kellogg 1 Published online: 22 April 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Traditional duodenal switch (DS) typically leaves a short common channel and is infrequently performed in part due to increased risk of malnutrition. We compared nutritional deficiencies between DS with a moderate channel length and standard proximal Roux-en-Y gastric bypass (RYGB). Methods We conducted a retrospective review of 61 matched pairs who underwent DS or RYGB using our institutional database; patients were matched on sex, age, race, and BMI. DS was performed with a common channel length between 120 and 150 cm. Thirty-day complications, total body weight loss (TBWL) %, and nutritional labs up to 24 months were compared using paired t test and Wilcoxon rank sum tests. Results Weight loss was similar at each time point (all p > 0.1). DS patients had lower vitamin D levels at 6 months, lower calcium levels at 6 and 12 months, and lower hemoglobin at 12 months and otherwise equivalent (all p < 0.05). Revision was rare (1 DS; 0 RYGB). There were no differences in short-term complications (p = 0.28). Conclusion DS with a moderate common channel length is safe with a low revision rate. Weight loss and nutritional outcomes appear to be comparable to RYGB, and it may be considered an effective RYGB alternative. Keywords Duodenal switch . Roux-en-Y gastric bypass . Common channel
Introduction Biliopancreatic diversion with duodenal switch is a wellestablished bariatric procedure that was first scribed in 1987. [1] Several studies have shown that compared with Roux-en Y
gastric bypass (RYGB), DS provides superior weight loss outcomes and better control of obesity-related comorbidities including diabetes mellitus type 2, hypertension, hyperlipidemia, and obstructive sleep apnea. [2, 3] Despite superior effectiveness at reducing weight, it represents less than 2%
* Todd A. Kellogg [email protected]
Maria L. Collazo-Clavell [email protected]
Alaa Sada [email protected]
Elizabeth B. Habermann [email protected]
Rolando D. Calderon-Rojas [email protected] Thomas Szabo Yamashita [email protected]
Travis J. McKenzie [email protected] 1
Department of Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN 55905, USA
2
Amy E. Glasgow [email protected]
Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
3
Michael L. Kendrick [email protected]
Department of Health Services Research, Mayo Clinic, Rochester, MN, USA
4
Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
Wendy S. Reidt Reidt.Wendy@mayo
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