Cambiar al Cruce bariátrico. A switch to the switch

  • Aniceto Baltasar Hospital Alcoy y Clínica San Jorge. Alcoy, Alicante
  • Nieves Pérez Hospital Alcoy y Clínica San Jorge. Alcoy, Alicante
  • Rafael Bou Hospital Alcoy y Clínica San Jorge. Alcoy, Alicante
  • Marcelo Bengochea Hospital Alcoy y Clínica San Jorge. Alcoy, Alicante
  • Carlos Serra Hospital Alcoy y Clínica San Jorge. Alcoy, Alicante
Palabras clave: Obesidad mórbida, Cruce duodenal, Cirugía bariátrica, Gastrectomía Vertical, Derivación biliopancreática, Pérdida de peso

Resumen

Introducción. El Cruce duodenal (CD) es un procedimiento bariátrico que combina una gastrectomía vertical  (GV) y una derivación bilio-pancreática (DBP) y consigue la mayor pérdida de sobreso perdido (PSP)  a largo plazo y resolución de comorbilidades.

Objetivos. Presentamos nuestra experiencia sobre 950 pacientes CD tratados desde 1994 a 2011 de obesidad mórbida (OM) desde 1994 a 2011 y 27 años de seguimiento en Hospital Comarcal de enseñanza e  Institución Privada de España.

Métodos. Estudio observacional, retrospectivo y longitudinal de 950 pacientes consecutivos tratados con cirugía de CD.

Resultados. Hubo 518 CD abiertos (CDA) y 432 CD laparoscópicos (CDL). Mortalidad operatoria del 0,84%  (1,38% en CDA y 0,38% en CDL), 4,84% incidencia de fugas, dos insuficiencia hepática (0,2%) y desnutrición  calórico proteica (DCP) en el 3,1%. A los 5 años, pérdida de del 80% de IMC y PSP de 90% y % perdido del IMC  esperado del 100%.

Conclusiones. El CD es la técnica bariátrica más agresiva, y con la mejor pérdida de peso a largo plazo. Se  describen las complicaciones operatorias y las pautas de seguimiento a largo plazo. Y se propone un cambio  para aceptar esta terapia.

 

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Citas

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Publicado
2019-09-15