Abstract of paper comparing BPD and gastric Banding

July 2, 2001

Surgical treatment of morbid obesity with biliopancreatic diversion

and gastric banding: report on an 8-year experience involving 235

cases.

Ann Chir 2000 Feb;125(2):155-62 (ISSN: 0003-3944)

Bajardi G; Ricevuto G; Mastrandrea G; Branca M; Rinaudo G; Cali F;

Diliberti S; Lo Biundo N; Asti V [Find other articles with these

Authors]

Dipartimento di Discipline Chirurgiche, Anatomiche ed Oncologiche,

Cattedra di Chirurgica Generale, Universita degli Studi di Palermo,

Italy.

STUDY AIM: Developments have recently been made in bariatric surgery

outside the USA. The aim of this retrospective non-randomized study

was to report on our experience regarding biliopancreatic diversion

(BPD) and non-adjustable gastric banding (GB) in a population of 235

obese patients. PATIENTS AND METHODS: From March 1990 to March 1998,

235 obese patients were operated on, 142 by BDP and 93 by GB, via

laparotomy after rigourous selection of the patient population.

RESULTS: The mean duration of surgery was 2 h 50 minutes for BPD and

1 h for GB. One postoperative death occurred due to massive pulmonary

embolism. Early major complications were frequent in the BPD group (n

= 21) but rare in the GB group (n = 1). Mean duration of

hospitalization was 16 days in the BPD group versus 9 days in the GB

group. Mean percentage excess weight loss was 48% for the GB group

and 60% for the BPD group after two years. Late mortality was limited

to the BPD group (3.5%). Late complications were evenly distributed

between the two groups, with a prevalence of malnutrition in the BPD

group and outlet stenosis in the GB group. A high incidence of band

removal was recorded related to this complication (17.2%). Incisional

hernias were present in both groups. CONCLUSIONS: GB and BPD are

techniques which can induce weight loss and bring about subsequent

health benefits. Nevertheless, in a few patients further intervention

or adaptation of the approach due to clinical failure or to a high

complication rate is required. Additional research is needed

regarding determination of the surgical treatment that is best

adapted to the case in question, i.e., taking into consideration both

the restrictive and malabsorbative aspects.

Hull

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