Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity: Long-Term Results and Metabolic Consequences
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Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity: Long-Term Results and Metabolic Consequences Alessandro Bianchi 1 & Alberto Pagan-Pomar 1 & Marina Jimenez-Segovia 1 & José Antonio Martinez-Corcoles 1 & Francesc Xavier Gonzalez-Argenté 1 Received: 23 December 2019 / Revised: 10 June 2020 / Accepted: 11 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose In the multidisciplinary therapeutic approach to obesity, bariatric surgery is considered the most effective treatment in weight reduction and the decrease in associated comorbidities. The objective of this work is to describe the long-term clinical and metabolic results in obese patients undergoing biliopancreatic diversion (BPD) according to Scopinaro’s technique. Materials and Methods Patients undergoing surgery were followed by the same multidisciplinary team in a study period of 15 years (1999–2015). A retrospective study based on a prospective database was designed, where data on the evolution of obesity-related diseases and nutritional parameters were studied. Results Two hundred seventy-seven patients were collected; 75.5% were women. The preoperative body mass index (BMI) decreased from 52.5 kg/m2 to 34.9 kg/m2 10 years after surgery. A resolution or improvement of diabetes has been observed in 85.38% of the patients; a decrease in arterial hypertension and obstructive sleep apnea syndrome were in 65.61% and 89.14%, respectively. Throughout the monitoring of the sample, protein malnutrition increased, from 1.8% after the first year of surgery to 4.5% 10 years after the operation. Conclusion Even if Scopinaro’s technique is beginning to be replaced by other malabsorptive techniques, it can still be considered as an effective surgical procedure in terms of weight loss, quality of life, and evolution of obesity-related diseases. In order to avoid nutritional deficiencies, the operated patients need a strict follow-up and a supplementation adjusted to the technique. Keywords Severe obesity, . Bariatric surgery, . Biliopancreatic diversion, . Long-term, . Nutritional complications
Introduction Obesity is a chronic multifactorial disease, with an epidemic and growing tendency, which predisposes to other multiple
* Alessandro Bianchi [email protected] Alberto Pagan-Pomar [email protected] Marina Jimenez-Segovia [email protected] José Antonio Martinez-Corcoles [email protected] Francesc Xavier Gonzalez-Argenté [email protected] 1
Department of General Surgery, Son Espases University Hospital, Ctra. de Valldemossa 79, 07010 Palma de Mallorca, Balearic Island, Spain
diseases such as type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), obstructive sleep apnoea (OSA), or hypercholesterolemia. It reduces quality of life, increases cardiovascular risk, and predisposes the patient to different types of cancer, increasing the risk of premature death [1]. The objective of surgery for morbid obesity is to produce a significant sustainable weight loss
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