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Early and long-term clinical outcomes of bilio-intestinal diversion in morbidly obese patients

Surgery Today volume 44, pages 1424–1433 (2014)Cite this article

Abstract

Purpose

To evaluate the early and long-term postoperative results of malabsorptive surgery in morbidly obese patients.

Methods

Between 2000 and 2007, 102 morbidly obese patients were referred to the Department of Surgery “Pietro Valdoni”, “Sapienza” University of Rome, Policlinico “Umberto I°”, Rome, Italy for malabsorptive surgery. All patients underwent derivative biliodigestive surgery after they had been reviewed by a team of surgeons, physicians, dieticians, and psychologists.

Results

There were no intra-operative complications, but two patients suffered postoperative pulmonary embolisms, which resolved with medical treatment. The mean postoperative hospital stay was 7 days, with no early or late mortality. Maximum weight loss was reached 12–24 months after surgery, while the mean percentage excess weight loss at 3–5 years ranged from 45 to 64 %. Specific postoperative complications in the first 2 years after surgery were abdominal abscess (n = 2), gastroduodenal reflux (n = 4), and incisional hernia (n = 6). Diabetes resolved in 98 % of the diabetic patients within a few weeks after surgery and blood pressure normalised in 86.4 % of those who had had hypertension preoperatively. Obstructive sleep apnoea and obesity hypoventilation syndrome also improved significantly in 92 % of the patients.

Conclusions

Morbidly obese patients can undergo biliodigestive surgery safely with good long-term weight loss and quality of life expectancy.

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Fig. 1

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Acknowledgments

The authors thank Mr. B. Luraschi for drawing Fig. 1.

Conflict of interest

Alessandro De Cesare, Barbara Cangemi, Enrico Fiori, Marco Bononi, Roberto Cangemi, Luigi Basso have no conflicts of interest.

Author information

Affiliations

  1. Department of Surgery “Pietro Valdoni”, “Sapienza” University of Rome, Faculty of Medicine and Dentistry, viale del Policlinico 155, 00161, Rome, Italy

    Alessandro De Cesare, Barbara Cangemi, Enrico Fiori, Marco Bononi & Luigi Basso

  2. Department of Internal Medicine and Medical Specialties, Policlinico “Umberto I”, viale del Policlinico 155, 00161, Rome, Italy

    Roberto Cangemi

Authors
  1. Alessandro De Cesare
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  2. Barbara Cangemi
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  3. Enrico Fiori
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  4. Marco Bononi
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  5. Roberto Cangemi
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  6. Luigi Basso
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Correspondence to Luigi Basso.

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De Cesare, A., Cangemi, B., Fiori, E. et al. Early and long-term clinical outcomes of bilio-intestinal diversion in morbidly obese patients. Surg Today 44, 1424–1433 (2014). https://doi.org/10.1007/s00595-014-0856-x

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  • DOI: https://doi.org/10.1007/s00595-014-0856-x

Keywords

  • Obesity
  • Morbid
  • Bypass
  • Biliodigestive
  • Outcome