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Laparoscopic vs. open biliopancreatic diversion with duodenal switch: a comparative study
Won-Woo Kim1, Michel Gagner2, Subhash Kini1
1Division of Laparoscopic Surgery, Director, Minimally Invasive Surgery Center, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1103, 10029, New York, NY.
Summary
Laparoscopic biliopancreatic diversion with duodenal switch (BPD-DS) offers effective weight loss comparable to open surgery in superobese patients. However, both methods carry significant risks, necessitating further research for optimal bariatric treatment.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Procedures
- Obesity Management
Background:
- Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective bariatric procedure for long-term weight loss.
- Superobesity (BMI >60) presents unique surgical challenges.
Purpose of the Study:
- To compare the safety and efficacy of laparoscopic BPD-DS versus open BPD-DS in superobese patients.
- To evaluate outcomes in terms of morbidity, mortality, and comorbidity improvement.
Main Methods:
- Retrospective study of 54 superobese patients (BMI >60) from July 1999 to June 2001.
- 26 patients underwent laparoscopic BPD-DS, and 28 underwent open BPD-DS.
- Comparison using unpaired t test.
Main Results:
- Major morbidity rates were similar: 23% (laparoscopic) vs. 17% (open), P = 0.63.
- Mortality rates were also similar: 7.6% (laparoscopic) vs. 3.5% (open), P = 0.51.
- Significant improvement in preoperative comorbidity was observed in 8 laparoscopic patients versus 2 open patients (P < 0.02).
Conclusions:
- Laparoscopic BPD-DS is technically feasible and achieves weight loss comparable to the open approach.
- Both laparoscopic and open BPD-DS are associated with considerable morbidity and mortality in superobese patients.
- Further studies are required to establish the optimal surgical treatment for superobesity.