Laparoscopic Biliopancreatic Diversion: Technique and Initial Results

Background: Biliopancreatic diversion (BPD) is an efficient method for treating morbid obesity.We present the BPD technique by laparoscopy and the 1st year follow-up. Methods: From July 2000 to April 2001, 40 patients underwent laparoscopic BPD (29 women, 11 men), with average age 39 (17-60). Average BMI was 43.6 kg/m2 (38-65). All operations were completed sucessfuly by laparoscopy. The technique followed strictly the operation of Scopinaro. 7 of these patients had removal of an adjustable gastric band and were converted to BPD. All underwent cholecystectomy. Results: Mean loss of initial excess weight at 3, 6 and 10 months was ≈ 30%, 50% and 90%. Mortality was 2.5% (1 patient) due to massive pulmonary embolism. Average operating time was 210 minutes (130-480), and average hospital stay was 4.3 days (3-21). There were 5 postoperative complications (12.5%): 2 pulmonary emboli, 2 GI bleeding from the staple-line, and 1 fistula.There have been 5 late complications (12.5%): 3 cases of diarrhea, 2 elevated PTH with normal calcium, and hypothyroidism that was dificult to control. Conclusion: BPD may be performed by laparoscopy without changes in the original technique or in the early results.