The bilio-intestinal bypass.

Area of Science:

• Bariatric Surgery
• Gastrointestinal Surgery
• Obesity Management

Background:

• The bilio-intestinal bypass (BIBP) has been utilized since 1990 for morbidly obese patients requiring malabsorptive procedures.
• Laparoscopic techniques for BIBP have been employed since 2001.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of bilio-intestinal bypass (BIBP) for morbid obesity.
• To compare outcomes between open and laparoscopic BIBP procedures.

Main Methods:

• A cohort of 102 patients with morbid obesity underwent BIBP, with 83 open and 19 laparoscopic procedures.
• The study involved jejunal and mesenteric sectioning, cholecysto-jejunal anastomosis, and ileal anastomosis with an anti-reflux valve.
• Follow-up averaged 10 years.

Main Results:

• Five years post-surgery, mean weight decreased to 89 kg and mean BMI to 31 kg/m2.
• The laparoscopic group experienced fewer complications, though two required conversion to open surgery due to adhesions.
• Late complications included incisional hernia (19.3%) and abdominal bloating (2.9%).

Conclusions:

• BIBP achieved satisfactory weight loss in 90.7% of patients five years post-procedure.
• Laparoscopic BIBP demonstrated benefits including reduced pain, shorter hospital stays, and fewer respiratory and thromboembolic complications.
• The laparoscopic approach also led to reduced convalescence time and lower rates of incisional hernia.