Notes from Dr. Marceau's 1998 paper

[Guest guest]

I though the group might be interested in my summary of Dr. Marcau's

paper from 1998:

Hull

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Marceau P; Hould FS; Simard S; Lebel S; Bourque RA; Potvin M,

Biliopancreatic diversion with duodenal switch., World journal of

surgery. 1998 Sep;22(9):947-54

Initial Characteristics of patients before BPD and BPD/DS:

Characteristic BPD BPD/DS

N 223 457

Age 37 +/- 9 37 +/- 10

Height (cm) 163 +/- 9 163 +/- 9

Weight (kg) 122 +/- 26 126 +/- 28

BMI 46 +/- 9 47 +/- 9

Excess Weight (%)101 +/- 37 105 +/- 39

Operative Mortality and morbidity and delayed mortality rates after

BPD & BPD/DS:

Parameter BPD BPD/DS

Operative Mortality 1.6% 1.9%

Operative Morbidity 16.7% 16.3%

Delayed Morbidity 2.4% 1.9%

Operative morbidity rate (by type):

Parameter BPD BPD/DS

Gastric retention 9.1% 6.2%

Pulmonary 3.6% 1.7%

Abdominal Abscess 0.4% 2.4%

Pancreatitis 0.8% 1.7%

Abdominal fistula 0.8% 1.7%

Wound infection 0.8% 1.0%

Others 2.0% 1.9%

Operative Mortalities:

Parameter BPD BPD/DS

Anastomotic leak and sepsis 1 4

Pancreatitis 2 0

Pulmonary embolus 1 3

Sleep Apnea 1

Malignant hyperthermia 1

Delayed Mortalities:

Parameter BPD BPD/DS

Cardiac 2 1

Cancer 2 1

Stroke 1

Pulmonary embolism 1

Septicemia 1

Complications following reoperation 1 3

Cirrhosis 1

Suicide 1

Weight loss after BPD and BPD/DS:

Parameter BPD BPD/DS

Mean follow-up (months) 100 +/- 20 51 +/- 25

Present weight (kg) 85 +/- 18 80 +/- 18

Obesity (%) 40 +/- 27 31 +/- 30

BMI (kg/m^2) 32 +/- 6 30 +/- 7

Weight loss (%) 30 +/- 12 36 +/- 10

Excess weight loss (%) 61 +/- 22 73 +/- 21

Weight loss (kg) 37 +/- 21 46 +/- 20

Maximum Weight loss (kg) 48 +/- 21 53 +/- 20

Eating Habits

Parameter BPD BPD/DS

Significant Food Restriction 14% 9%

Vomiting at least once per week 15% 6%

Side effects:

Parameter BPD BPD/DS

Abdominal Bloating 38% 36%

Diarrhea 14% 7%

Stool Odor 43% 34%

Liquid Stool Consistency 29% 20%

Heartburn / Abdominal pain 15% 15%

Bone Pain 41% 29%

Frequency of bowel movements 58% 40%

Blood tests:

Parameter Pre-Op BPD BPD/DS

Iron Deficiency 13% 20% 9%

Low serum ferritin 4% 40% 25%

Low serum calcium 4% 16% 8%

High PTH - 30% 17%

Vitamin A - 12% 5%

Hemoglobin 2% 9% 6%

Vitamin B12 3% 3% 3%

P 0% 4% 2%

AlkPh 2% 3% 3%

Malnutrition:

Parameter BPD BPD/DS

Revision Rate 1.7% 0.1%

Hospitalization Rate 1.72% 0.93%