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Biliopancreatic Diversion with Duodenal Switch in the Elderly: Long-Term Results of a Matched-Control Study

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Abstract

Background

Biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective surgical approaches for the treatment of severe obesity.

Objective

The objective of this study is to compare perioperative complications and long-term results of open BPD-DS in elderly versus younger patients.

Methods

All patients aged 60 years and above who underwent a primary open BPD-DS in our center were selected (n = 105). Patients were matched 1:1 for sex, BMI, the presence of type 2 diabetes (T2DM), and year of surgery with a group of younger patients (aged ≤55 years).

Results

The mean age of the patients was 62.3 ± 2.0 vs. 40.4 ± 7.0 years (p ≤ 0.0001). Initial BMI and prevalence of T2DM were similar in both groups, at 50.9 kg/m2 and 57 %, respectively. Mean operative time (178.6 ± 46.7 vs. 162.5 ± 39.9 min, p = 0.01), hospital stay (10.2 ± 8.3 vs. 6.3 ± 1.5 days, p = 0.0001), and blood loss (593 ± 484 vs. 474 ± 241 ml, p = 0.05) were significantly higher in elderly patients. No difference in 30-day mortality rate was observed (0.9 % in each group). There was no significant difference in major complication rate (16.2 vs. 8.6 %, p = 0.09). At a mean follow-up of 7.1 ± 4.1 years, excess weight loss (67.6 ± 19.2 vs. 72.7 ± 20.7 %, p = 0.06) and BMI (32.2 ± 5.7 vs. 30.8 ± 6.6 kg/m2, p = 0.15) were not significantly different. No significant difference was observed between the two groups for the resolution of T2DM (p = 0.53) and obstructive sleep apnea (p = 0.44).

Conclusions

Open BPD-DS is associated with similar long-term benefits in elderly and younger patients, in terms of weight loss and resolution or improvement of obesity-related comorbidities. Perioperative complications might be more frequent in the elderly population, but this was not associated with increased mortality.

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Acknowledgments

The authors would like to acknowledge the help of Paule Marceau, the data bank coordinator.

Funding

Andréanne Michaud was funded by Fonds de recherche de Québec-Santé.

Conflict of Interest

A. Tchernof and L. Biertho are codirectors of a Research chair in bariatric and metabolic surgery. A. Michaud, G. B. Marchand, M. Nadeau, S. Lebel, FS. Hould, S. Marceau, O. Lescelleur, S. Biron, A. Tchernof, and L. Biertho have no financial relationships relevant to this manuscript to disclose.

Ethical Approval

For this type of study, formal consent is not required. This study received approval from the ethics committee of our institution.

Informed Consent

Does not apply.

Author information

Authors and Affiliations

  1. Centre de recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Canada

    Andréanne Michaud, Geneviève B. Marchand, Mélanie Nadeau & André Tchernof

  2. School of Nutrition, Laval University, Québec City, Canada

    Andréanne Michaud, Geneviève B. Marchand & André Tchernof

  3. Division of Bariatric and General Surgery, Department of Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Québec City, G1V 4G5, Canada

    Stéfane Lebel, Frédéric-Simon Hould, Simon Marceau, Odette Lescelleur, Simon Biron & Laurent Biertho

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  1. Andréanne Michaud
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Correspondence to Laurent Biertho.

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Michaud, A., Marchand, G.B., Nadeau, M. et al. Biliopancreatic Diversion with Duodenal Switch in the Elderly: Long-Term Results of a Matched-Control Study. OBES SURG 26, 350–360 (2016). https://doi.org/10.1007/s11695-015-1772-x

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  • DOI: https://doi.org/10.1007/s11695-015-1772-x

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