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Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity: Long-Term Results and Metabolic Consequences

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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.

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Acknowledgments

We are extremely grateful for the collaboration of all the nursing staff, the help of the endocrinology department, and to all those who, during all these years, have helped with the operations, have assessed the consultations of the patients intervened, and have compiled the presented data.

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Authors and Affiliations

  1. Department of General Surgery, Son Espases University Hospital, Ctra. de Valldemossa 79, 07010, Palma de Mallorca, Balearic Island, Spain

    Alessandro Bianchi, Alberto Pagan-Pomar, Marina Jimenez-Segovia, José Antonio Martinez-Corcoles & Francesc Xavier Gonzalez-Argenté

Authors
  1. Alessandro Bianchi
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  2. Alberto Pagan-Pomar
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  3. Marina Jimenez-Segovia
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  4. José Antonio Martinez-Corcoles
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  5. Francesc Xavier Gonzalez-Argenté
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Contributions

APP and JAMC were the main surgeons. MJS helped in the literature search. XFGA supervised the performance of the work. AB wrote the article and participated in the operations. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Alessandro Bianchi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Bianchi, A., Pagan-Pomar, A., Jimenez-Segovia, M. et al. Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity: Long-Term Results and Metabolic Consequences. OBES SURG 30, 4234–4242 (2020). https://doi.org/10.1007/s11695-020-04777-w

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  • DOI: https://doi.org/10.1007/s11695-020-04777-w

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