Abstract
Background
Traditional duodenal switch (DS) typically leaves a short common channel and is infrequently performed in part due to increased risk of malnutrition. We compared nutritional deficiencies between DS with a moderate channel length and standard proximal Roux-en-Y gastric bypass (RYGB).
Methods
We conducted a retrospective review of 61 matched pairs who underwent DS or RYGB using our institutional database; patients were matched on sex, age, race, and BMI. DS was performed with a common channel length between 120 and 150 cm. Thirty-day complications, total body weight loss (TBWL) %, and nutritional labs up to 24 months were compared using paired t test and Wilcoxon rank sum tests.
Results
Weight loss was similar at each time point (all p > 0.1). DS patients had lower vitamin D levels at 6 months, lower calcium levels at 6 and 12 months, and lower hemoglobin at 12 months and otherwise equivalent (all p < 0.05). Revision was rare (1 DS; 0 RYGB). There were no differences in short-term complications (p = 0.28).
Conclusion
DS with a moderate common channel length is safe with a low revision rate. Weight loss and nutritional outcomes appear to be comparable to RYGB, and it may be considered an effective RYGB alternative.
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Study conception and design: Alaa Sada, Elizabeth Habermann, Michael Kendrick, Wendy Reidt, Travis McKenzie, and Todd Kellogg. Acquisition of data: Alaa Sada, Rolando Calderon-Rojas, Thomas Szabo Yamashita, Amy Glasgow, and Wendy Reidt. Analysis and interpretation of data: Alaa Sada, Elizabeth Habermann, Amy Glasgow, Wendy Reidt, Maria Collazo-Clavell, and Todd Kellogg. Drafting of manuscript: Alaa Sada, Rolando Calderon-Rojas, Thomas Szabo Yamashita, Wendy Reidt, Amy Glasgow, Michael Kendrick, Maria Collazo-Clavell, Elizabeth Habermann, Travis McKenzie, and Todd Kellogg.
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Sada, A., Calderon-Rojas, R.D., Yamashita, T.S. et al. Outcomes of Duodenal Switch with a Moderate Common Channel Length and Roux-en-y Gastric Bypass: Does One Pose More Risk?. OBES SURG 30, 2870–2876 (2020). https://doi.org/10.1007/s11695-020-04619-9
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DOI: https://doi.org/10.1007/s11695-020-04619-9