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Interesting....
Just noticed a few new papers came out recently (edited to fix how it looks and some weird formatting errors):
Cir Esp. 2012 Jan;90(1):45-52. Epub 2011 Dec 15.
[Metabolic changes after morbid obesity surgery using the duodenal switch technique. Long term follow-up]. [Article in Spanish]
Vázquez Prado A, Vázquez Tarragón A, Sancho Moya C, Ismail Mahmoud A, De Tursi Rispoli L, Bruna Esteban M, Cabrera IF, Cantos Pallarés M, Mulas Fernández C, Puche Plá J.
Servicio de Cirugía, Hospital General Universitario, Valencia, España. [email protected]
Abstract
INTRODUCTION:
The duodenal switch (DS) technique is considered to be complex surgery with a series of metabolic complications due to its malabsorptive character. For these reasons, it has not been extensively used by bariatric surgeons. Despite this, we consider it to be a suitable technique for the grossly obese.
PATIENTS AND METHODS:
A retrospective study was performed on 110 patients with morbid obesity operated on using the DS technique and who were followed up for a minimum period of four years after surgery. We evaluated the weight loss, the outcomes of the comorbidities, and the metabolic complications.
RESULTS:
The loss of excess weight was greater than 50% in 75% of the patients after 12 months follow up. The comorbidities suffered by 68 patients (75.5%) were completely resolved. The most frequent metabolic complications were iron (Fe) deficiency and an increased parathyroid hormone (PTH).
CONCLUSIONS:
DS is a safe and effective technique for the treatment of morbid obesity, with good weight loss results, a high percentage of remission of the comorbidities, a similar morbidity and mortality to other techniques, and with correctable nutritional changes, and thus acceptable.
Surg Obes Relat Dis. 2012 Feb 1. [Epub ahead of print]
Superior weight loss and lower HbA1c 3 years after duodenal switch compared with Roux-en-Y gastric bypass-a randomized controlled trial.
Hedberg J, Sundbom M.
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND:
Obesity is a rising threat to public health. The relative increase in the incidence of morbid obesity is most pronounced in the most severely obese. Roux-en-Y gastric bypass (RYGB) results in inferior weight loss in this group. Therefore, we have offered biliopancreatic diversion with duodenal switch (BPD/DS) as an alternative for this patient category. Our objective was to compare BPD/DS and RYGB in the surgical treatment of morbid obesity in patients with a body mass index (BMI) >48 kg/m(2). The setting was a university hospital in Sweden.
METHODS:
In a controlled trial (registration number ISRCTN10940791), 47 patients (25 men, BMI 54.5 ± 6.1 kg/m(2)) were randomized to RYGB (n = 23) or BPD/DS (n = 24). Biochemical data were collected preoperatively and 1 and 3 years postoperatively. A questionnaire addressing weight, general satisfaction, and gastrointestinal symptoms was distributed a median of 4 years postoperatively.
RESULTS:
Both procedures were safe. The duration of surgery and postoperative morphine consumption were greater after BPD/DS than after RYGB (157 versus 117 min and 140 versus 93 mg, respectively). BPD/DS resulted in greater weight loss than RYGB (-23.2 ± 4.9 versus -16.2 ± 6.9 BMI units or 80% ± 15% versus 51% ± 23% excess BMI loss, P 48 kg/m(2). Both operations yield high satisfaction rates. However, diarrhea tended to be more common after BPD/DS.
This one is from the Madigan Army Base, with Dr. Martin:
Am J Surg. 2012 Mar 8. [Epub ahead of print]
The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.
Nelson D, Porta R, Blair K, Carter P, Martin M.
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
Abstract
BACKGROUND:
Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.
METHODS:
Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.
RESULTS:
A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.
Read more: http://weightlosssurgery.proboards.com/index.cgi?action=disp lay&board=general&thread=3129&page=1#45058#ixzz1q3HWNtc3
Just noticed a few new papers came out recently (edited to fix how it looks and some weird formatting errors):
Cir Esp. 2012 Jan;90(1):45-52. Epub 2011 Dec 15.
[Metabolic changes after morbid obesity surgery using the duodenal switch technique. Long term follow-up]. [Article in Spanish]
Vázquez Prado A, Vázquez Tarragón A, Sancho Moya C, Ismail Mahmoud A, De Tursi Rispoli L, Bruna Esteban M, Cabrera IF, Cantos Pallarés M, Mulas Fernández C, Puche Plá J.
Servicio de Cirugía, Hospital General Universitario, Valencia, España. [email protected]
Abstract
INTRODUCTION:
The duodenal switch (DS) technique is considered to be complex surgery with a series of metabolic complications due to its malabsorptive character. For these reasons, it has not been extensively used by bariatric surgeons. Despite this, we consider it to be a suitable technique for the grossly obese.
PATIENTS AND METHODS:
A retrospective study was performed on 110 patients with morbid obesity operated on using the DS technique and who were followed up for a minimum period of four years after surgery. We evaluated the weight loss, the outcomes of the comorbidities, and the metabolic complications.
RESULTS:
The loss of excess weight was greater than 50% in 75% of the patients after 12 months follow up. The comorbidities suffered by 68 patients (75.5%) were completely resolved. The most frequent metabolic complications were iron (Fe) deficiency and an increased parathyroid hormone (PTH).
CONCLUSIONS:
DS is a safe and effective technique for the treatment of morbid obesity, with good weight loss results, a high percentage of remission of the comorbidities, a similar morbidity and mortality to other techniques, and with correctable nutritional changes, and thus acceptable.
Surg Obes Relat Dis. 2012 Feb 1. [Epub ahead of print]
Superior weight loss and lower HbA1c 3 years after duodenal switch compared with Roux-en-Y gastric bypass-a randomized controlled trial.
Hedberg J, Sundbom M.
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND:
Obesity is a rising threat to public health. The relative increase in the incidence of morbid obesity is most pronounced in the most severely obese. Roux-en-Y gastric bypass (RYGB) results in inferior weight loss in this group. Therefore, we have offered biliopancreatic diversion with duodenal switch (BPD/DS) as an alternative for this patient category. Our objective was to compare BPD/DS and RYGB in the surgical treatment of morbid obesity in patients with a body mass index (BMI) >48 kg/m(2). The setting was a university hospital in Sweden.
METHODS:
In a controlled trial (registration number ISRCTN10940791), 47 patients (25 men, BMI 54.5 ± 6.1 kg/m(2)) were randomized to RYGB (n = 23) or BPD/DS (n = 24). Biochemical data were collected preoperatively and 1 and 3 years postoperatively. A questionnaire addressing weight, general satisfaction, and gastrointestinal symptoms was distributed a median of 4 years postoperatively.
RESULTS:
Both procedures were safe. The duration of surgery and postoperative morphine consumption were greater after BPD/DS than after RYGB (157 versus 117 min and 140 versus 93 mg, respectively). BPD/DS resulted in greater weight loss than RYGB (-23.2 ± 4.9 versus -16.2 ± 6.9 BMI units or 80% ± 15% versus 51% ± 23% excess BMI loss, P 48 kg/m(2). Both operations yield high satisfaction rates. However, diarrhea tended to be more common after BPD/DS.
This one is from the Madigan Army Base, with Dr. Martin:
Am J Surg. 2012 Mar 8. [Epub ahead of print]
The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.
Nelson D, Porta R, Blair K, Carter P, Martin M.
Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
Abstract
BACKGROUND:
Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.
METHODS:
Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.
RESULTS:
A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.
Read more: http://weightlosssurgery.proboards.com/index.cgi?action=disp lay&board=general&thread=3129&page=1#45058#ixzz1q3HWNtc3
Thanks for posting.
I recently found an article in the New England Journal of Medicine discussing two studies on weight loss surgery and its effect on type 2 diabetes.
I posted links to this article. Basically the two studies showed that 75% of gastric bypass patients were cured of their diabetes, while 95% of the duodenal switch patients were cured. 95%!! That's astounding.
And what's even more astounding is that the weight loss surgery patients saw improvement in their blood sugar even before they lost any weight!
As part of these two studies, there was a group of people who tried medication and diet to control their diabetes, and they showed no improvement whatsoever.
I'm kind of glossing over the whole thing. Read my post for the full story. It's pretty cool, I thought.
I recently found an article in the New England Journal of Medicine discussing two studies on weight loss surgery and its effect on type 2 diabetes.
I posted links to this article. Basically the two studies showed that 75% of gastric bypass patients were cured of their diabetes, while 95% of the duodenal switch patients were cured. 95%!! That's astounding.
And what's even more astounding is that the weight loss surgery patients saw improvement in their blood sugar even before they lost any weight!
As part of these two studies, there was a group of people who tried medication and diet to control their diabetes, and they showed no improvement whatsoever.
I'm kind of glossing over the whole thing. Read my post for the full story. It's pretty cool, I thought.
First Surgery Date: November 5, 2005
Surgery Type: RNY--Proximal
Height: 5' 3"
Beginning Weight: 250 lbs.
Lowest Weight: 125 lbs.
Current Weight: 230 lbs. Seeking Revision to DS
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