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Ten years of follow-up of bilio-intestinal bypass: is malabsorption necessary for long-term metabolic results?

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Abstract

Background

Bilio-intestinal bypass (BIBP) is an uncommon bariatric procedure. In 1999, a prospective trial was started at our institution to evaluate the effectiveness of BIBP. Trial was interrupted in 2006 due to high rate of complications. The aim of the present paper was to retrospectively review 10-year outcomes of BIBP.

Methods

Retrospective review of bariatric database was performed to find patients that had undergone BIBP from 1999 to 2006. Data collected were as follows: age, gender, body weight, body mass index (BMI), percentage of excess weight loss (%EWL), remission from weight-related diseases, complications, and deaths at 1,3, 5, 7, and 10 years. Quality of life was evaluated using “BAROS” questionnaire.

Results

From May 1999 to September 2006, 86 patients underwent BIBP. The mean age was 34.9 ± 22.4 years, and the initial weight and BMI were 141.2 ± 40.4 kg and 49.8 ± 15.5 kg/m2, respectively. After 10 years, the mean %EWL and BMI were 72.6 ± 18.7 and 31.2 ± 5.6 kg/m2. Almost all patients had diarrhea after surgery. Bloating syndrome occurred in 24% of patients, 48% had nephrolithiasis, and 20.9% had cholelithiasis. Remission from diabetes and hypertension was obtained in 75% and 80% of patients. Mortality was 3.2% and reoperation rate was 14.5%.

Conclusions

Malabsorption plays a determinant role to obtain a long-lasting treatment for obese patients. However, BIBP is not recommendable due to high rate of complications and metabolic disorders.

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Authors and Affiliations

  1. Department of Endocrinology, Gastroenterology and Surgery, University Hospital of Naples “Federico II”, Naples, Italy

    Antonio Vitiello, Antonio Formato, Giuliano Izzo, Luca Ferraro & Pietro Forestieri

  2. Department of Medicine Surgery and Dentistry, University Hospital of Salerno, Salerno, Italy

    Pilone Vincenzo

Authors
  1. Antonio Vitiello
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  2. Pilone Vincenzo
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  3. Antonio Formato
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  4. Giuliano Izzo
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  5. Luca Ferraro
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  6. Pietro Forestieri
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Correspondence to Antonio Vitiello.

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The authors declare that they have no conflict of interest.

Ethical approval

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.

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

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Vitiello, A., Vincenzo, P., Formato, A. et al. Ten years of follow-up of bilio-intestinal bypass: is malabsorption necessary for long-term metabolic results?. Langenbecks Arch Surg 403, 873–879 (2018). https://doi.org/10.1007/s00423-018-1717-7

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  • DOI: https://doi.org/10.1007/s00423-018-1717-7

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