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Biliopancreatic diversion with transitory gastroplasty preserving duodenal bulb: 3 years experience
C Vassallo1, L Negri, A Della Valle
1Interdisciplinary Centre of Obesity, Surgical Division, Stradella's Hospital, Italy.
Background:
The authors have performed 521 bariatric surgery operations (319 restrictive procedures and 202 malabsorptive procedures).
Methods:
During the last few years we have introduced an evolution of biliopancreatic diversion (BPD): BPD with transitory gastroplasty, preserving the duodenal bulb (53 cases). From a technical point of view, the operation consists of a BPD, coupled with a gastroplasty which is transitory due to the use of a polydioxanone (PDS) band. In the last few cases, instead of a VBG (with PDS band) in order to make the operation completely reversible without any suture on the stomach, we made a gastric pouch by banding with PDS calibrated with the same tube as for the Lap-band (20 cc). We maintained completely the duodenal bulb (5 cm from the pylorus), making an end-to-side duodeno-ileal isoperistaltic anastomosis.
Results:
With this anastomosis, only 2% of patients developed an anastomotic ulcer. With this new procedure, results have been good in terms of weight loss (similar to that of BPD-AHS) and in nutritional complications. No patient has had hypoalbuminemia, diarrhea or halitosis.
Conclusion:
BPD with temporary gastric restriction has provided satisfactory results.