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Long-term comparative study on open versus laparoscopic biliopancreatic diversion

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Abstract

Background

To date, bariatric surgery has been proposed as the most effective treatment to resolve morbid obesity, a multifactorial chronic disease with an epidemic and increasing tendency. The purpose of this study was to determinate the impact of the laparoscopy on weight loss parameters in morbid obese patients who underwent surgery according to Scopinaro’s biliopancreatic diversion (BPD) and evaluate early and late complications related to the open and laparoscopic approach of this technique.

Materials and methods

This is a longitudinal retrospective study in consecutive patients undergoing BPD due to morbid obesity between 1999 and 2015. From 2006 the laparoscopic technique was introduced in our group for obesity surgery. In both approaches, open and laparoscopic surgery, the procedure performed consists of a proximal gastric section with a long Roux-en-Y reconstruction. The following variables were assessed in the two groups: intervention duration (min), estimated blood loss (mL), conversions to open approach (%), preoperative stay, postoperative and global stay (days). Complications were divided into early and late postoperative complications. The early surgical complications were catalogued according to the Clavien–Dindo classification.

Results

Two hundred seventy-seven patients were consecutively enrolled and divided in two groups: open BPD and laparoscopic BPD. There were no significant differences in the comparison of the two groups and the mean age was 43.9 years (19–60) with a mean BMI of 52.5 kg/m2. A statistically significant reduction was observed in favor of the laparoscopic group with respect to the reduction in hospital stay and in the incidence of incisional hernia as a late complication. No statistically significant difference were found with respect to early postoperative complications.

Conclusions

Laparoscopic BPD is a safe technique that allows a shorter hospital stay compared to open surgery and that allows a drastic reduction in the incidence of incisional hernias.

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Acknowledgements

We are extremely grateful for the collaboration of all the nursing staff, the help of the 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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There were no sources of financing for the realization of this paper.

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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 & Francesc Xavier Gonzalez-Argenté

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  1. Alessandro Bianchi
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  2. Alberto Pagan-Pomar
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  3. Marina Jimenez-Segovia
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  4. Francesc Xavier Gonzalez-Argenté
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Correspondence to Alessandro Bianchi.

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Alessandro Bianchi, Alberto Pagan-Pomar, Marina Jimenez-Segovia and Francesc Xavier Gonzalez-Argenté have no conflict of interest or financial ties to disclose.

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Bianchi, A., Pagan-Pomar, A., Jimenez-Segovia, M. et al. Long-term comparative study on open versus laparoscopic biliopancreatic diversion. Surg Endosc 36, 1164–1171 (2022). https://doi.org/10.1007/s00464-021-08383-4

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