Obesity Surgery

, Volume 5, Issue 4, pp 411–418

Biliopancreatic Diversion with a New Type of Gastrectomy: Some Previous Conclusions Revisited

  • Marc Lagacé
  • Picard Marceau
  • Simon Marceau
  • Frédéric-Simon Hould
  • Martin Potvin
  • Roch-André Bourque
  • Simon Biron
Article

DOI: 10.1381/096089295765557511

Cite this article as:
Lagacé, M., Marceau, P., Marceau, S. et al. OBES SURG (1995) 5: 411. doi:10.1381/096089295765557511

Background: In 1990, we modified Scopinaro's biliopancreatic diversion (BPD); instead of a distal gastrectomy and gastroileal anastomosis, a parietal gastrectomy was performed with nutrients diverted through a duodenal switch. Also, the length of the common channel (50 cm) was doubled to 100 cm, while the nutrient limb remained 250 cm. In 1991, we reported initial results after 16 months: weight loss was as expected following BPD, but patients reported fewer side-effects and the prevalence of excessive malabsorption was less. This cohort of patients had their duodenum stapled shut to construct the duodenal switch. This staple-line failed insidiously in some patients, allowing the duodenum to recanalize partially or completely. This resulted in an incomplete BPD. Methods: Since 1992, the duodenal switch has been constructed with a complete transection of the duodenum to prevent recanalization. We report here on the first 61 patients who underwent this definitive procedure. Results: At 16 months, we observed a mean weight loss of 84% of initial excess weight, the number of daily stools at 2.9 ± 1.6 and the prevalence of diarrhea at 10%. Twenty per cent of patients experienced mild anaemia, hypocalcemia, or hypoalbuminemia, which required added supplements. Conclusions: BPD with parietal gastrectomy, duodenal switch and longer common channel improved weight loss and decreased gastrointestinal side-effects without an increased prevalence of excessive malabsorption. The parietal gastrectomy may contribute to weight loss by increasing satiety, and decreasing side-effects by regulating gastric emptying.

Bariatric surgerybiliopancreatic diversionmalabsorptiongastric surgerymorbid obesity

Copyright information

© Springer 1995

Authors and Affiliations

  • Marc Lagacé
    • Picard Marceau
      • Simon Marceau
        • Frédéric-Simon Hould
          • Martin Potvin
            • Roch-André Bourque
              • Simon Biron

                There are no affiliations available