Results of Biliopancreatic Diversion after Five Years
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- Guedea, M.E., Arribas del Amo, D., Solanas, J.A.G. et al. OBES SURG (2004) 14: 766. doi:10.1381/0960892041590809
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Background: Gastric restrictive procedures, currently the most popular surgical operations for morbid obesity, have proved to be effective in initiating weight loss, but questions regarding their long-term efficacy in weight maintenance have arisen. Biliopancreatic diversion (BPD) is a mixed and complex technique that has shown good long-term results. There are no series with long-term follow-up of BPD in Spain. We present >5 year results (average 67.9 ± 15 SD mons, range 48-96), evaluating weight loss, morbidity and mortality after BPD. Methods: 74 patients who underwent BPD and completed 5 or more years of follow-up were studied. The results have been analyzed in terms of weight loss (classification of Reinhold), improvement in morbidity, and improvement in quality of life (BAROS). Results: 78.6% were women. Mean age was 38 ± 11 years (18-61). Mean preoperative body mass index (BMI) was 54 ± 8 kg/m2. Progression of BMI: 1 year 34 ± 6, 2 years 31 ± 6, 5 years 33 ± 7 and 7 years 31 ± 3 kg/m2 . Excess weight loss at 1 year follow-up was 67%, at 2 years 75%, at 5 years 70% and at 7 years 71%. There were significant differences between morbidly obese (BMI <50 kg/m2) and super-obese (BMI >50 kg/m2 ), with better results in the morbidly obese group. Conclusion: BPD shows long-term effectiveness in weight loss, co-morbidity improvement and quality of life. Protein, vitamin and oligoelement deficits may appear in the long-term, so that strict follow-up and supplementation of deficiencies are necessary.