A switch to the Duodenal Switch

Authors

  • 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

DOI:

https://doi.org/10.19230/jonnpr.3116

Keywords:

Morbid obesity, Duodenal Switch, Bariatric surgery, Sleeve-Forming Gastrectomy, Biliary pancreatic diversion, Weight loss

Abstract

Background. Duodenal Switch (DS) is a procedure that combines a Sleeve-Forming Gastrectomy (SFG) plus a biliopancreatic diversion (BPD) for the treatment of morbid obesity (MO) with a higher weight loss and resolution of comorbidities.

Objectives. Report our experience with 950 consecutive DS operations performed from 1994 to 2016. Setting. Mix of teaching and private institution in a county hospital of Spain.

Methods. We report an observational, retrospective and longitudinal study of 950 consecutive morbidly obese patients treated by DS surgery.

Results. We performed 518 open and 432 laparoscopic DS. Operative mortality was 0.84% (1.38% in DS and 0.38% in LDS), 4.84% had leaks, two had hepatic failures (0.2%) and malnutrition was present in 3.1%. At 5 years, the percentage of BMI lost was 80%, and percentage of expected BMI loss was more than  100%.

Conclusions. DS is the most aggressive bariatric surgery (BS) technique, but with the best long-term weight loss. We describe operative complications and long-term follow-up guidelines.

 

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Published

2019-09-15