Some more words from Dr. Poires on BPD and BPD/DS

[Guest guest]

Hi Everyone,

I found more quotes from Dr. Poires. These seem to verify what I

posted last month. Interestingly he specifies here that Italians can

do well with the procedure, but not americans. We eat to much butter

and not enough olive oil!

You can find the full text of the article at:

http://www.contemporarysurgery.com/03_00/symposia.pdf

The relavant portions are included below:

Hull

_ M A L A B S O R P T I V E P R O C E D U R E S

S U G E R M A N : What are your thoughts on the

malabsorptive procedures, including the partial biliopancreatic

bypass of Dr. Scopinaro from Genoa, Italy,

and the duodenal switch operations of Drs. Hess and

Marceau?9,10

P O R I E S : Dr. Scopinaro's biliopancreatic bypass

struck me as a rather outlandish procedure, but

his good results may in part be due to the typical

Italian diet. But I don't think it's an acceptable operation

for American patients.

The duodenal switch is still new, and regarded as

an experimental procedure. I think it's promising and

appears to be somewhat easier to do, but I don't have

any long-term data.

DOHERTY: The Scopinaro procedure results

in an obligatory weight loss because of the amount of

malabsorption. So, for these patients to stay in a good

state of nutrition, some of them are consuming 6,000-

7,000 calories a day. Most of them are easy to identify,

because of frequent and malodorous flatus.

S U G E R M A N : I have met many of the Italian

patients who have had the biliopancreatic bypass and

I was impressed by how well they are doing. I have

seen the data. Our patients in the United States eat

larger quantities of fat, and that's going to markedly

increase steatorrhea and malodorous flatus. When I

was in Italy I questioned whether their patients' stools

floated because I was interested in steatorrhea, but

they don't have standing-water flush toilets.

P O R I E S : I think that may be a clue—there is

quite a difference between butter and olive oil. The

answers regarding Scopinaro's approach are not in,

but the finding that Italians do well and Americans do

poorly after the procedure is fascinating, and must

relate to diet.