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A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up

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Abstract

Background

The Roux-en-Y gastric bypass (GBP) has been considered the gold standard for many years. The loop duodenal switch (LDS) is a relatively new procedure that simplifies the complexity of the duodenal switch (BPDDS) by making it a single anastomosis procedure while at the same time giving it more intestinal absorption to reduce the rates of malnutrition associated with traditional BPDDS. This paper seeks to compare the 18-month weight loss outcomes and complications of the more standard GBP with the newer LDS in a single US center.

Methods

A retrospective matched cohort was analyzed on 108 patients who had either GBP (54 patients) or LDS (54 patients). Regression analysis was used to compare weight loss outcomes as measured by BMI and weight loss percentages. Complications gathered included bleeds, reoperations, diagnostic or therapeutic endoscopy (EGD), ulcers and chronic nausea.

Results

GBP and LDS have statistically similar weight loss at 18 months (39.6 vs 41 % weight loss, respectively). However, there were significantly more nausea complaints (26 vs 5), diagnostic endoscopies (EGD) (21 vs 3) and ulcers (6 vs 0) with the GBP than the LDS.

Conclusion

LDS has comparable weight loss results to GBP. However, LDS has fewer 30-day and 18-month complications and patients suffer from less nausea postoperatively.

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Authors and Affiliations

  1. Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT, 84102, USA

    Austin Cottam, Daniel Cottam, Walter Medlin, Christina Richards, Samuel Cottam, Hinali Zaveri & Amit Surve

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  1. Austin Cottam
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  2. Daniel Cottam
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  3. Walter Medlin
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  5. Samuel Cottam
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  7. Amit Surve
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Correspondence to Daniel Cottam.

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Disclosures

Austin Cottam, Daniel Cottam, Walter Medlin, Christina Richards, Samuel Cottam, Hinali Zaveri and Amit Surve have no conflicts of interest or financial ties to disclose.

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Cottam, A., Cottam, D., Medlin, W. et al. A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up. Surg Endosc 30, 3958–3964 (2016). https://doi.org/10.1007/s00464-015-4707-7

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  • DOI: https://doi.org/10.1007/s00464-015-4707-7

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