World Journal of Surgery

, Volume 28, Issue 5, pp 435–444 | Cite as

Biliopancreatic Diversion in the Surgical Treatment of Morbid Obesity

  • Robrecht H.G.G. Van Hee
Editorial Update

Abstract

Biliopancreatic diversion is a malabsorptive technique of bariatric surgery that has gained wide acceptance in the Western world. It is performed in one of two ways: In its classic form it consists of partial gastrectomy with a Roux-en-Y gastroenterostomy; in its duodenal switch form a vertical sleeve gastrectomy is combined with a duodenoenterostomy. Both techniques realize diversion of biliopancreatic juice, thereby creating a mild form of malabsorption. Weight loss has been approximately 70% of initial excess weight, exceeding that obtained with most other bariatric procedures. Iron, calcium, and vitamin deficiencies may occur, especially with classic biliopancreatic diversion, and must be prevented with adequate supplements during vigorous follow-up. Weight loss is followed by a substantial reduction in the co-morbidities that are present in many morbidly obese patients. Biliopancreatic diversion should be included in each obesity clinic program and be proposed for morbidly obese patients who are having difficulty with the prospect of continuous restraint of food intake or problems due to failed gastric restrictive interventions. The postoperative results in such patients have been good and have substantially improved quality of life and self-esteem in this category of morbidly obese patients.

References

  1. 1.
    Kluthe, R, Schubert, A 1985Obesity in EuropeAnn. Intern. Med.10310371042PubMedGoogle Scholar
  2. 2.
    Flegal, KM, Kuczmarski, RJ, Johnson, CL 1998Overweight and obesity in the United States: prevalence and trends, 1960-1994Int. J. Obes.223947CrossRefGoogle Scholar
  3. 3.
    Macdonald, SM, Reeder, BA, Chen, Y,  et al. 1996Canadian Heart Health Surveys Research Group: obesity in Canada: a descriptive analysisCan. Med. Assoc. J.15S3Google Scholar
  4. 4.
    Encuesta Nacional de Enfermedades Cronicas. Secretaria de Salud, Mexico. (National Survey on Chronic Diseases, Secretary of Health, Mexico), General Direction of Epidemiology, Mexico, 1996;15–24Google Scholar
  5. 5.
    Stam-Moraga, M, Kolanowski, J, Dramaix, M,  et al. 1999Sociodemographic and nutritional determinants of obesity in BelgiumInt. J. Obes.2319CrossRefGoogle Scholar
  6. 6.
    Mason, EE, Tang, S, Renquist, KE,  et al. 1997A decade of change in obesity surgeryObes. Surg.7189197CrossRefPubMedGoogle Scholar
  7. 7.
    Buchwald, H 2002Overview of bariatric surgeryJ. Am. Coll. Surg.194367376CrossRefPubMedGoogle Scholar
  8. 8.
    Buchwald, H, Buchwald, JN 2002Evolution of operative procedures for the management of morbid obesity 1950-2000Obes. Surg.12705717CrossRefPubMedGoogle Scholar
  9. 9.
    Deitel, M 1996The development of general surgical operations, and weight-loss operationsObes. Surg.6206213CrossRefPubMedGoogle Scholar
  10. 10.
    Van Hee, R 1993

    De evolutie van de heelkunde tijdens de laatste 100 jaar [The evolution of surgery in the last 100 years]

    Van Hee, RCosta, PMendes, R eds. Société Royale Belge de Chirurgie, 1893-1993, Koninklijk Belgisch Genootschap voor HeelkundeUniversaWetteren1142
    Google Scholar
  11. 11.
    Halverson, JD, Scheff, RJ, Gentry, K,  et al. 1980Jejunoileal bypass: late metabolic sequelae and weight gainAm. J. Surg.140347350PubMedGoogle Scholar
  12. 12.
    Hocking, MD, Duerson, MC, O’Leary, JP,  et al. 1983Jejunoileal bypass for morbid obesityN. Engl. J. Med.308995999PubMedGoogle Scholar
  13. 13.
    McFarland, RJ, Gazet, J-C, Pilkington, TRE 1985A 13-year review of jejunoileal bypassBr. J. Surg.728187PubMedGoogle Scholar
  14. 14.
    Sagar, PM 1995Surgical treatment of morbid obesityBr. J. Surg.82732739PubMedGoogle Scholar
  15. 15.
    Kral, JG 1992Overview of surgical techniques for treating obesityAm. J. Clin. Nutr.55S552S555Google Scholar
  16. 16.
    Kolanowski, J 1997Surgical treatment for morbid obesityBr. Med. Bull.53433444PubMedGoogle Scholar
  17. 17.
    Miller, K, Rettenbacher, L, Hell, E 1996Adjustments and leak detection of the adjustable silicone gastric band (ASGB) and Lap-band adjustable gastric band (LAGB) systemObes. Surg.6406411CrossRefPubMedGoogle Scholar
  18. 18.
    Eckhout, GV, Willbanks, OL, Moore, JT 1986Vertical ring gastroplasty for obesity: five year experience with 1463 patientsAm. J. Surg.152713716PubMedGoogle Scholar
  19. 19.
    Mason, EE, Maher, JW, Doherty, C,  et al. 1992Ten years of vertical banded gastroplasty for severe obesityProbl. Gen. Surg.9280289Google Scholar
  20. 20.
    Linner, JH 1984

    Gastric operations

    Linner, JH eds. Surgery for Morbid ObesitySpringerNew York65107
    Google Scholar
  21. 21.
    Scopinaro, N, Papadia, F 2001

    Malabsorptive procedures

    Schein, MWise, L eds. Controversies in Surgery, vol. 4SpringerNew York353360
    Google Scholar
  22. 22.
    Marceau, P, Hould, FS, Lebel, S,  et al. 2001Malabsorptive obesity surgerySurg. Clin. North Am.8111131127Google Scholar
  23. 23.
    Noya, G, Cossu, ML, Coppola, M,  et al. 1998Biliopancreatic diversion for treatment of morbid obesity: experience in 50 casesObes. Surg.86166CrossRefPubMedGoogle Scholar
  24. 24.
    Lemmens, L 1993Biliopancreatic diversion: 170 patients in a 7-years follow-upObes. Surg.3179180CrossRefPubMedGoogle Scholar
  25. 25.
    Holian, DK, Clare, MW 1991Biliopancreatic diversion for malignant obesityContemp. Surg.392629Google Scholar
  26. 26.
    Tacchino, RM, Nanni, G, Foco, M,  et al. 1998Biliopancreatic diversion for treatment of obesity: 1987-1997 experienceObes. Surg.8369370Google Scholar
  27. 27.
    Gasbarrini, G, Mingrone, G, Greco, AV,  et al. 1996An 18-year-old woman with familial chylomicronaemia who would not stick to a dietLancet348794CrossRefPubMedGoogle Scholar
  28. 28.
    Scopinaro, N, Adami, GF, Marinari, GM,  et al. 1998Biliopancreatic diversionWorld J. Surg.22936946CrossRefPubMedGoogle Scholar
  29. 29.
    International Federation for the Surgery of Obesity (I.F.S.O.). Patient selection for bariatric surgery. http://www.obesity-online.com/ifso/ifso-selection.htmGoogle Scholar
  30. 30.
    Muls E. editor (2001) Obesitas: de Consensus van de BASO [Obesity: Consensus Statement of the Belgian Association for the Study of Obesity], Praktische Gids, 1–54Google Scholar
  31. 31.
    Guidelines for laparoscopic and open surgical treatment of morbid obesity (2000) American Society for Bariatric Surgery and Society of American Gastrointestinal Endoscopic Surgeons. Obes Surg. 10:378–379Google Scholar
  32. 32.
    Quételet AJ (1835) Sur l’homme et le Développement de ses Facultés, ou Essai de Physique Sociale, Paris, BachelierGoogle Scholar
  33. 33.
    Guidelines for Patient Selection and Postoperative Follow-up Care in Surgical Treatment of Obesity. The American Society for Bariatric Surgery, 5–94Google Scholar
  34. 34.
    Scheen, A, Luyckx, F, Desaive, C,  et al. 1999Severe/extreme obesity: a medical disease requiring a surgical treatment?Acta Clin. Belg.54154161PubMedGoogle Scholar
  35. 35.
    National Institutes of Health Consensus Development Conference statement1992Gastrointestinal surgery for severe obesityAm. J. Clin. Nutr.55S615S619Google Scholar
  36. 36.
    Scheen, A, Luyckx, F, Desaive, C,  et al. 1999Severe/extreme obesity: a medical disease requiring a surgical treatment?Acta Clin. Belg.54154161PubMedGoogle Scholar
  37. 37.
    Gastrointestinal surgery for severe obesity: consensus development conference panel (1991) Ann. Intern. Med. 115:956-961Google Scholar
  38. 38.
    Renquist, K 1998Obesity classificationObes. Surg.8480CrossRefPubMedGoogle Scholar
  39. 39.
    Kral, JG, Brolin, RE, Buchwald, H,  et al. 2002Research considerations in obesity surgeryObes. Res.106364PubMedGoogle Scholar
  40. 40.
    Deitel, M, Shahi, B 1992Morbid obesity: selection of patients for surgeryJ. Am. Coll. Nutr.11457462PubMedGoogle Scholar
  41. 41.
    Buchwald, H 2002A bariatric surgery algorithmObes. Surg.12733746CrossRefPubMedGoogle Scholar
  42. 42.
    Kissebah, AH, Freedman, DS, Peiris, AN 1989Health risks of obesityMed. Clin. North Am.73111138PubMedGoogle Scholar
  43. 43.
    Khaodhiar, L, Blackburn, GL 2001Obesity assessmentAm. Heart J.14210951101CrossRefPubMedGoogle Scholar
  44. 44.
    Desaive, C 1996Surgery for morbid obesityActa Chir. Belg.96192196PubMedGoogle Scholar
  45. 45.
    Johnson, B, Bjorvell, H, Levander, S,  et al. 1986Personality traits predicting weight loss outcome in obese patientsActa Psychiatr. Scand.74384387PubMedGoogle Scholar
  46. 46.
    Stunkard, AJ, Stinnet, JL, Smoller, JW 1986Psychological and social aspects of the surgical treatment of obesityAm. J. Psychiatry143417429PubMedGoogle Scholar
  47. 47.
    Guisado, JA, Vaz, FJ 2003Personality profiles of the morbidly obese after vertical banded gastroplastyObes. Surg.13394398CrossRefPubMedGoogle Scholar
  48. 48.
    Balsiger, BM, Luque-de-Leon, E, Sarr, MG 1997Surgical treatment of obesity: who is an appropriate candidate?Mayo Clin. Proc.72551558PubMedGoogle Scholar
  49. 49.
    Fox, SR 1991The use of biliopancreatic diversion as a treatment for failed gastric partitioning in the morbidly obeseObes. Surg.18993CrossRefPubMedGoogle Scholar
  50. 50.
    Brolin, RE 2001

    Gastric restrictive operations

    Schein, MWise, L eds. Controversies in Surgery, vol. 4SpringerNew York343352
    Google Scholar
  51. 51.
    Totté, E, Hendrickx, L, Pauwels, M,  et al. 2001Weight reduction by means of intragastric device: experience with the Bioenterics Intragastric BalloonObes. Surg.11519523CrossRefPubMedGoogle Scholar
  52. 52.
    Weiner, R, Gutberlet, H, Brockhorn, H 1998Pre-surgical treatment of extremely obese patients with the intragastric balloonObes. Surg.8367368Google Scholar
  53. 53.
    Waele, B, Reynaert, H, Urbain, D,  et al. 2000Intragastric balloons for preoperative weight reductionObes. Surg.105860CrossRefPubMedGoogle Scholar
  54. 54.
    Scopinaro, N, Gianetta, E, Civalleri, D,  et al. 1979Biliopancreatic by-pass for obesity. I. An experimental study in dogsBr. J. Surg.66613617PubMedGoogle Scholar
  55. 55.
    Scopinaro, N, Gianetta, E, Civalleri, D,  et al. 1979Biliopancreatic by-pass for obesity. II. Initial experience in manBr. J. Surg.66618620PubMedGoogle Scholar
  56. 56.
    Scopinaro, N, Gianetta, E, Civalleri, D,  et al. 1980Two years of clinical experience with biliopancreatic bypass for obesityAm. J. Clin. Nutr.33506514PubMedGoogle Scholar
  57. 57.
    Marceau, P, Biron, S, Bourque, R-A,  et al. 1993Biliopancreatic diversion with a new type of gastrectomyObes. Surg.32935CrossRefPubMedGoogle Scholar
  58. 58.
    Hess, DS 1994Biliopancreatic diversion with a duodenal switch procedureObes. Surg.4106CrossRefGoogle Scholar
  59. 59.
    Meester, T-R, Fuchs, KH, Ball, CS,  et al. 1987Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric refluxAnn. Surg.206414426PubMedGoogle Scholar
  60. 60.
    Lagacé, M, Marceau, P, Marceau, S,  et al. 1995Biliopancreatic diversion with a new type of gastrectomy: some previous conclusions revisitedObes. Surg.5411418CrossRefPubMedGoogle Scholar
  61. 61.
    Baltasar, A, Bou, R, Cipagantu, LA,  et al. 1995Hybrid bariatric surgery: biliopancreatic diversion and duodenal switch; preliminary experienceObes. Surg.5419423CrossRefPubMedGoogle Scholar
  62. 62.
    Rabkin, RA 1998Distal gastric bypass/duodenal switch procedure, Roux-en-Y gastric bypass and biliopancreatic diversion in a community practiceObes. Surg.85359CrossRefPubMedGoogle Scholar
  63. 63.
    Anthone GJ. Surgical treatment of morbid obesity. American College of Surgeons postgraduate course, October 1997Google Scholar
  64. 64.
    Vassallo, C, Negri, L, Valle, A,  et al. 1997Biliopancreatic diversion with transitory gastroplasty preserving duodenal bulb: 3 years experienceObes. Surg.73033CrossRefPubMedGoogle Scholar
  65. 65.
    Mittempergher, F, Bruni, T, Bruni, O,  et al. 2002Biliopancreatic diversion with preservation of the duodenal bulb and transitory gastroplasty in the treatment of morbid obesity: our experienceAnn. Ital. Chir.73137142PubMedGoogle Scholar
  66. 66.
    Yashkov, YI, Oppel, TA, Shishlo, LA,  et al. 2001Improvement of weight loss and metabolic effects of vertical banded gastroplasty by an added duodenal switch procedureObes. Surg.11635639CrossRefPubMedGoogle Scholar
  67. 67.
    Totté, E, Hendrickx, L, Van Hee, R 1999Biliopancreatic diversion for treatment of morbid obesity: experience in 180 consecutive casesObes. Surg.9161165CrossRefPubMedGoogle Scholar
  68. 68.
    Scopinaro, N, Gianetta, E, Adami, GF,  et al. 1996Biliopancreatic diversion for obesity at eighteen yearsSurgery119261268PubMedGoogle Scholar
  69. 69.
    Torres, JC, Oca, CF, Garrison, RN 1983Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvatureSouth. Med. J.7612171221PubMedGoogle Scholar
  70. 70.
    Torres, J, Oca, C 1987Gastric bypass lesser curvature with distal Roux-en-YBariatric Surg.51015Google Scholar
  71. 71.
    Torres, J 1991Why I prefer gastric bypass distal Roux-en-Y gastroileostomyObes. Surg.1189194CrossRefPubMedGoogle Scholar
  72. 72.
    Fobi MAL. Distal Roux-en-Y-gastric bypass, a revision operation for failed gastric bypass procedures. In Proceedings, Fourth Annual Symposium Surgical Treatment of Obesity, Anaheim, March 1986Google Scholar
  73. 73.
    Brolin, RE, Kenler, HA, Gorman, JH,  et al. 1992Long limb gastric bypass in the super-obese: a prospective randomized studyAnn. Surg.215387395PubMedGoogle Scholar
  74. 74.
    Gianetta E, Friedman D, Adami GF, et al. Present status of biliopancreatic diversion (BPD). In Proceedings of the Third International Symposium on Obesity Surgery, Genoa, September 1987;11–13Google Scholar
  75. 75.
    Deitel, M, Petrov, I 1987Incidence of symptomatic gallstones after bariatric operationsSurg. Gynecol. Obstet.164549552PubMedGoogle Scholar
  76. 76.
    Bajardi, G, Ricevuto, G, Mastrandrea, G,  et al. 1993Opportunità della colecistectomia profilattica in chirurgica bariatricaMinerva Chir.48277Google Scholar
  77. 77.
    Pavia, D, Bernardes, L, Suretti, L 2001Laparoscopic biliopancreatic diversion for the treatment of morbid obesity: initial experienceObes. Surg.11619622CrossRefPubMedGoogle Scholar
  78. 78.
    Scopinaro, N, Marinari, GM, Camerini, G 2002Laparoscopic standard biliopancreatic diversion: technique and preliminary resultsObes. Surg.12362365CrossRefPubMedGoogle Scholar
  79. 79.
    Csepel, J, Burpee, S, Jossart, G,  et al. 2001Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigsJ. Laparoendosc. Adv. Surg. Tech. A117983CrossRefPubMedGoogle Scholar
  80. 80.
    Ren, CJ, Patterson, E, Gagner, M 2000Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patientsObes. Surg.10514523CrossRefPubMedGoogle Scholar
  81. 81.
    Feng, JJ, Gagner, M 2002Laparoscopic biliopancreatic diversion with duodenal switchSemin. Laparosc. Surg.9125129CrossRefPubMedGoogle Scholar
  82. 82.
    Csepel, J, Quinn, T, Pomp, A,  et al. 2002Conversion to a laparoscopic biliopancreatic diversion with a duodenal switch for failed laparoscopic adjustable silicone gastric bandingJ. Laparoendosc. Adv. Surg. Tech. A12237240CrossRefPubMedGoogle Scholar
  83. 83.
    Gagner, M, Steffen, R, Biertho, L,  et al. 2003Laparoscopic adjustable gastric banding with duodenal switch for morbid obesity: technique and preliminary resultsObes. Surg.13444449CrossRefPubMedGoogle Scholar
  84. 84.
    Rabkin, RA, Rabkin, JM, Metcalf, B,  et al. 2003Laparoscopic technique for performing duodenal switch with gastric reductionObes. Surg.13263268CrossRefPubMedGoogle Scholar
  85. 85.
    Favretti, F, Cadière, GB, Segato, G,  et al. 2002Laparoscopic banding: selection and technique in 830 patientsObes. Surg.12385390CrossRefPubMedGoogle Scholar
  86. 86.
    Belachew, M, Belva, PH, Desaive, C 2002Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesityObes. Surg.12564568CrossRefPubMedGoogle Scholar
  87. 87.
    Vertruyen, M 2002Experience with Lap-Band System up to 7 yearsObes. Surg.12569572CrossRefPubMedGoogle Scholar
  88. 88.
    Weiner, R, Blanco-Engert, R, Weiner, S,  et al. 2003Outcome after laparoscopic adjustable gastric banding: 8 years experienceObes. Surg.13427434CrossRefPubMedGoogle Scholar
  89. 89.
    Martin, LF 1998White S., Lindstrom W. Cost-benefit analysis for the treatment of severe obesityWorld J. Surg.2210081017CrossRefPubMedGoogle Scholar
  90. 90.
    Holian, DK, Clare, MW 1986Biliopancreatic bypass for morbid obesity: late results and complicationsClin. Nutr.5133136CrossRefGoogle Scholar
  91. 91.
    Marceau, P, Biron, S, St.Georges, R,  et al. 1991Biliopancreatic diversion with gastrectomy as surgical treatment of morbid obesityObes. Surg.1381386CrossRefPubMedGoogle Scholar
  92. 92.
    Scopinaro, N, Adami, GF, Marinari, GM,  et al. 2000

    Biliopancreatic diversion: two decades of experience

    Deitel, M.Cowa, SM, Jr eds. Update: Surgery for the Morbidly Obese PatientFD-CommunicationsToronto227258
    Google Scholar
  93. 93.
    Michielsen, D, Van Hee, R, Hendrickx, L 1996Complications of biliopancreatic diversion surgery as proposed by Scopinaro in the treatment of morbid obesityObes. Surg.6416420CrossRefPubMedGoogle Scholar
  94. 94.
    Sugerman, HJ, Kellum, JM, Reines, D,  et al. 1996Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene meshAm. J. Surg.1718081CrossRefPubMedGoogle Scholar
  95. 95.
    Gianetta, E, Friedman, D, Traverso, E,  et al. 1992Small bowel obstruction after biliopancreatic diversionProbl. Gen. Surg.9386Google Scholar
  96. 96.
    Schein, M 1987Acute pancreatitis following pancreaticobiliary bypass (Scopinaro operation)Arch. Surg.1221088Google Scholar
  97. 97.
    Marceau, P, Hould, F-S, Simard, S,  et al. 1998Biliopancreatic diversion with duodenal switchWorld J. Surg.22947954CrossRefPubMedGoogle Scholar
  98. 98.
    Compston, JE, Vedi, S, Gianetta, E,  et al. 1984Bone histomorphometry and vitamin D status after biliopancreatic bypass for obesityGastroenterology87350356PubMedGoogle Scholar
  99. 99.
    Compston, JE, Vedi, S, Watson, GJ,  et al. 1986Metabolic bone disease in patients with biliopancreatic bypassClin. Nutr.5221224CrossRefGoogle Scholar
  100. 100.
    Chapin, BL, Mar, HJ,Jr, Knodel, DH,  et al. 1996Secondary hyperparathyroidism following biliopancreatic diversionArch. Surg.13110481053PubMedGoogle Scholar
  101. 101.
    Vanuytsel, J, Nobels, F, Van Gaal, L,  et al. 1993A case of malnutrition after biliopancreatic diversion for morbid obesityInt. J. Obes.17425426Google Scholar
  102. 102.
    Bonalumi, U, Cafiero, F, Caponnetto, A,  et al. 1981Protein absorption studies in biliopancreatic bypass patientsInt. J. Obes.5543Google Scholar
  103. 103.
    Scopinaro, N, Marinari, GM, Gianetta, E,  et al. 1997The respective importance of the alimentary limb (AL) and the common limb (CL) in protein absorption (PA) after BPDObes. Surg.7168Google Scholar
  104. 104.
    Gianetta, E, Friedman, D, Adami, GF,  et al. 1987Etiological factors of protein malnutrition after biliopancreatic diversionGastroenterol. Clin. North Am.16503504PubMedGoogle Scholar
  105. 105.
    Primavera, A, Brusa, G, Novello, P,  et al. 1993Wernicke Korsakoff encephalopathy following biliopancreatic diversionObes. Surg.3175177CrossRefPubMedGoogle Scholar
  106. 106.
    Quaranta, L, Nascimbeni, G, Semeraro, F,  et al. 1994Severe corneoconjunctival xerosis after biliopancreatic bypass for obesity (Scopinaro’s operation)Am. J. Ophthalmol.118817818PubMedGoogle Scholar
  107. 107.
    Cantatore, FP, Carrozzo, M, Loperfido, MC 1991Post biliopancreatic bypass arthritis: dermatitis syndromeClin. Rheumatol.10449451PubMedGoogle Scholar
  108. 108.
    Grimm, IS, Schindler, W, Haluszka, O 1992Steatohepatitis and fatal hepatic failure after biliopancreatic diversionAm. J. Gastroenterol.87774779Google Scholar
  109. 109.
    Biron, S, Marceau, S, Dejoie, C,  et al. 1996Effects of weight loss after biliopancreatic diversion on liver morphologyObes. Surg.6121Google Scholar
  110. 110.
    Gaudio, A, Boschi, L, Gaudio, GA,  et al. 2002Liver damage in obese patientsObes. Surg.12802804CrossRefPubMedGoogle Scholar
  111. 111.
    Gholam, PM, Kotler, DP, Flancbaum, LJ 2002Liver pathology in morbidly obese patients undergoing Roux-en-Y gastric bypass surgeryObes. Surg.124951CrossRefPubMedGoogle Scholar
  112. 112.
    Spaulding, L, Trainer, T, Janiec, D 2003Prevalence of non-alcoholic steatohepatitis in morbidly obese subjects undergoing gastric bypassObes. Surg.13347349CrossRefPubMedGoogle Scholar
  113. 113.
    Allison, DB, Fontaine, KR, Manson, JE,  et al. 1999Annual deaths attributable to obesity in the United StatesJAMA28215301538PubMedGoogle Scholar
  114. 114.
    Calle, EE, Rodriguez, C, Walker-Thurmond, K,  et al. 2003Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adultsN. Engl. J. Med.34816251638CrossRefPubMedGoogle Scholar
  115. 115.
    Sjöström, LV 1992Mortality of severely obese subjectsAm. J. Clin. Nutr.55S516S523Google Scholar
  116. 116.
    Patterson, EJ, Urbach, DR, Swanström, LL 2003A comparison of diet and exercise therapy versus laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity: a decision analysis modelJ. Am. Coll. Surg.196379384CrossRefPubMedGoogle Scholar
  117. 117.
    To, TB, Deitel, M, Stone, E,  et al. 1987Sex hormonal changes after loss of massive excess weightSurg. Forum38465467Google Scholar
  118. 118.
    Deitel, M, To, TB, Stone, E,  et al. 1987Sex hormonal changes accompanying loss of massive excess weightGastroenterol. Clin. North Am.16511515PubMedGoogle Scholar
  119. 119.
    Pasquali, R, Vicennati, V, Scopinaro, N,  et al. 1997Achievement of near-normal body weight as the prerequisite to normalise sex hormone-binding globulin concentration in morbidly obese menInt. J. Obes.2115CrossRefGoogle Scholar
  120. 120.
    Gerrits, EG, Ceulemans, R, Van Hee, R,  et al. 2003Contraceptive treatment after biliopancreatic diversion needs consensusObes. Surg.13378382CrossRefPubMedGoogle Scholar
  121. 121.
    Richards, DS, Miller, DK, Goodman, GN 1987Pregnancy after gastric bypass for morbid obesityJ. Reprod. Med.32172176PubMedGoogle Scholar
  122. 122.
    Treadwell, L, Mason, EE, Scott, DA,  et al. 1993Pregnancy outcome after vertical banded gastroplastyObes. Surg.3143Google Scholar
  123. 123.
    Wittgrove, AC, Jester, L, Wittgrove, P,  et al. 1998Pregnancy following gastric bypass for morbid obesityObes. Surg.8461464CrossRefPubMedGoogle Scholar
  124. 124.
    Deitel, M, Ternamian, AM 2000

    Gynecologic-obstetric features of morbid obesity and the effect of weight loss

    Deitel, MCowan Jr., GSM eds. Update: Surgery for the morbidly obese patientFD-CommunicationsToronto481485
    Google Scholar
  125. 125.
    Friedman, D, Cuneo, S, Valenzano, M,  et al. 1995Pregnancies in an 18-year follow-up after biliopancreatic diversionObes. Surg.5308313CrossRefPubMedGoogle Scholar
  126. 126.
    Adami, GF, Friedman, D, Cuneo, S,  et al. 1992Intravenous nutritional support in pregnancy: experience following biliopancreatic diversionClin. Nutr.11106109CrossRefGoogle Scholar
  127. 127.
    Amaral, JF, Thompson, WR, Caldwell, MD,  et al. 1985Prospective hematologic evaluation of gastric exclusion surgery for morbid obesityAnn. Surg.201186193PubMedGoogle Scholar
  128. 128.
    Simon, SR, Zemel, R, Betancourt, S,  et al. 1989Hematologic complications of gastric bypass for morbid obesitySouth. Med. J.8211081110PubMedGoogle Scholar
  129. 129.
    Hess, DW, Hess, DS 1998Biliopancreatic diversion with a duodenal switchObes. Surg.8267282CrossRefPubMedGoogle Scholar
  130. 130.
    Rhode, BM, McLean, LD 2000

    Vitamin and mineral supplementation after gastric bypass

    Deitel, MCowan Jr., GSM eds. Update: Surgery for the Morbidly Obese PatientsFD-communicationsToronto161170
    Google Scholar
  131. 131.
    Brolin, RE, Leung, M 1999Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesityObes. Surg.9150154CrossRefPubMedGoogle Scholar
  132. 132.
    Byrne, TK 2001Complications of surgery for obesitySurg. Clin. North Am.8111811194Google Scholar
  133. 133.
    O’Brien, PE, Nixon, JB, Brown, W,  et al. 2002The laparoscopic adjustable gastric band (Lap-Band®): a prospective study of medium-term effects on weight, health and quality of lifeObes. Surg.12652660CrossRefPubMedGoogle Scholar
  134. 134.
    Meir, E, Van Baden, M 1999Adjustable silicone gastric banding and band erosion: personal experience and hypothesesObes. Surg.9191193CrossRefPubMedGoogle Scholar
  135. 135.
    Hell, E, Miller, KA 2000

    Comparison of vertical banded gastroplasty and adjustable silicone gastric banding

    Deitel, MCowan Jr., GSM eds. Update: Surgery for the Morbidly Obese PatientFD-CommunicationsToronto379386
    Google Scholar
  136. 136.
    DeMaria, EJ, Sugerman, HJ, Meador, JG,  et al. 2001High failure rate after laparoscopic adjustable silicon gastric banding for treatment of morbid obesityAnn. Surg.233809818CrossRefPubMedGoogle Scholar
  137. 137.
    Misset M, Fabry H, Van Hee R, et al. Laparoscopic adjustable gastric banding with up to 6-year follow-up: is it really safe and affective? Acta Chir. Belg. in pressGoogle Scholar
  138. 138.
    Chelala, E, Cadière, GB, Favretti, F,  et al. 1997Conversions and complications in 185 laparoscopic adjustable silicone gastric banding casesSurg. Endosc.11268271CrossRefPubMedGoogle Scholar
  139. 139.
    Niville, E, Dams, A 1999Late pouch dilation after laparoscopic adjustable gastric and esophagogastric banding: incidence, treatment and outcomeObes. Surg.9381384CrossRefPubMedGoogle Scholar
  140. 140.
    Morino, M, Toppino, M, Garrone, C 1997Disappointing long-term results of laparoscopic adjustable silicone gastric bandingBr. J. Surg.84868869CrossRefPubMedGoogle Scholar
  141. 141.
    Westling, A, Bjurling, K, Ohrvall, M,  et al. 1998Silicone-adjustable gastric banding: disappointing resultsObes. Surg.8467474CrossRefPubMedGoogle Scholar
  142. 142.
    Van Hee, R 1999Bariatric surgery: a view on the futureG. Chir.207379PubMedGoogle Scholar
  143. 143.
    Sugerman, HJ, Londrey, GL, Kellum, JM,  et al. 1989Weight loss with vertical banded gastroplasty and Roux-Y gastric bypass for morbid obesity with selective versus random assignmentAm. J. Surg.15793100PubMedGoogle Scholar
  144. 144.
    Sugerman, HJ, DeMaria, EJ, Kellum, JM 2003Sweet eating is not a predictor of outcome after Lap-Band® placement?Obes. Surg.13468471CrossRefPubMedGoogle Scholar
  145. 145.
    Larsen, F 1990Psychological function before and after gastric banding surgery for morbid obesity: a prospective psychiatric studyActa Psychiatr. Scand.82S1S57Google Scholar
  146. 146.
    Mason, EE, Hesson, WW 1998Informed consent for obesity surgeryObes. Surg.8419428CrossRefPubMedGoogle Scholar
  147. 147.
    Savage, RC 1983Abdominoplasty following gastrointestinal bypass surgeryPlast. Reconstr. Surg.71500507PubMedGoogle Scholar
  148. 148.
    Fuente del Campo, A, Rojas Allegretti, E, Fernandes Filho, JA 1998et al. Regional dermolipectomy as treatment for sequelae of massive weight lossWorld J. Surg.22974980CrossRefPubMedGoogle Scholar
  149. 149.
    Floros, C, Davis, KB 1991Complications and long-term results following abdominoplasty: a retrospective studyBr. J. Plast. Surg.44190194PubMedGoogle Scholar
  150. 150.
    Soundarajan, V, Hart, NB, Royston, CMS 1995Abdominoplasty following vertical banded gastroplasty for morbid obesityBr. J. Plast. Surg.48423427PubMedGoogle Scholar
  151. 151.
    Pitanguy, I 1971Surgical reduction of the abdomen, thigh and buttocksSurg. Clin. North Am.51479489PubMedGoogle Scholar
  152. 152.
    Grazer, FM 1973Abdominoplasty. Plast. Reconstr. Surg.51617623Google Scholar
  153. 153.
    Lowis S, Van Hee R, Peeters R, et al. Abdominoplasty after biliopancreatic diversion for morbid obesity. Br. J. Plast. Surg. in pressGoogle Scholar
  154. 154.
    Grazer, FM, Goldwyn, RM 1977Abdominoplasty assessed by survey, with emphasis on complicationsPlast. Reconstr. Surg.59513517PubMedGoogle Scholar
  155. 155.
    Uchelen, JH, Werker, PNM, Kon, M 2001Complications of abdominoplasty in 86 patientsPlast. Reconstr. Surg.10718691873CrossRefPubMedGoogle Scholar
  156. 156.
    Hensel, JM, Lehman, JA, Tantri, MP,  et al. 2001An outcomes analysis and satisfaction survey of 199 consecutive abdominoplastiesAnn. Plast. Surg.46357363CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2004

Authors and Affiliations

  • Robrecht H.G.G. Van Hee
    • 1
  1. 1.Academic Surgical Center StuivenbergUniversity of AntwerpAntwerpenBelgium

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