Long-term 10 to 15 year outcomes of biliopancreatic diversion with duodenal switch

Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective and sustainable treatment for obesity but concerns regarding its long-term outcomes persist.

Contribute to the long-term data around weight loss, comorbidity, and complication outcomes of BPD-DS SETTING: Academic medical center, USA METHODS: A retrospective study included patients undergoing laparoscopic BPD-DS between 2008 and 2014 to allow for ≥ 10-year follow-up. Baseline characteristics, intraoperative data, weight loss outcomes, obesity-related medical condition remission and recurrence, and complication rates were collected. Statistical analysis included t-tests, Pearson's Chi-Square test, Kaplan-Meier curves, linear mixed models and multivariate regression.

Ninety-six patients were included with a mean follow-up period of 11.6 ± 4.2 years and 60.5% follow-up rate at 15 years. Significant body mass index (BMI) reductions (P < .001) were observed at every time point. Percentage total weight loss (%TWL) and excess BMI loss were consistently > 20% and >50%, respectively, over the entire follow-up period. A longer common channel (150 cm) was associated with a lower %TWL. Among the comorbidities tracked, patients with diabetes experienced the highest remission rate (88.6%), followed by hyperlipidemia (63.6%), hypertension (63.0%) and sleep apnea (59.0%). Early and late complication rates were 27.1% and 45.8%, respectively. Seven patients needed revisional surgery for severe malnutrition, bowel obstruction, intussusception, and duodenoileostomy stenosis. Nutritional deficiencies were frequently encountered.

BPD-DS offers sustainable weight loss and obesity-related medical condition remission outcomes. Its safety profile warrants consistent follow-up to manage nutritional problems.