The Impact of Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Over 9 Years
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There is limited information on the multiple long-term effects of the biliopancreatic diversion with duodenal switch (BPD/DS).
Patients who consented to a BPD/DS from 1999 to 2010 were evaluated for weight change, complications, comorbidity resolution, body composition, quality of life, and depressive symptoms during visits at 1, 3,5, 7, and 9 years. Descriptive statistics, analysis of variance, and pair-wise comparisons were calculated for each of the five follow-up cohorts vs. the baseline cohort.
Between 1999 and 2010, 284 patients received a BPD/DS; 275 patients (69.8 % women) age 42.7 years, BMI 53.4 kg/m2 qualified for baseline analysis. Two hundred seventy-five patients were available in year 1; 275 patients in year 3; 273 patients in year 5; 259 patients in year 7; and 228 patients in year 9. Gender distribution was not different. BMI was 30.1 at 1 year and 32.0 at 9 years. Body fat was reduced to 26 % after 2 years. Complications requiring surgery were significant. Nutritional problems developed in 29.8 % of patients over the course of observation. The baseline Beck Depression Index (BDI) was 13.9 and 7.2 in year 1. Year 1 through 9 remained unchanged. There were significant positive changes in quality of life between baseline and year 1 for most domains. These positive changes were maintained for the follow-up cohorts. After surgery the resolution of comorbidities continued for the 9 years.
Weight loss during the first year was well maintained, resolving comorbidities and improving quality of life. Rates of surgical complications resemble other bariatric procedures. Long-term nutrient deficiencies are of concern.
KeywordsObesity surgery Biliopancreatic diversion with the duodenal switch Quality of life after bariatric surgery Bariatric surgery complications Body composition after surgical weight loss
We thank Dr. Paul Christos and Gülce Askin, MPH, for their assistance with the data analysis. They were partially supported by the following grant: Clinical and Translational Science Center at Weill Cornell Medical College (UL1-TR000457-06). We are grateful for the efforts of Maureen Moore, MD for her contribution to the assessment of surgical complications. Sara Hassen deserves mention for her input into the body composition data analysis. The Department of Surgery at Weill Cornell School of Medicine supported this project.
Compliance with Ethical Standards
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.
All authors report no conflict of interest relevant to the contents of this manuscript.
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