Superior results in terms of the percentage of excess weight loss (%EWL) have been ascribed to the biliopancreatic diversion with duodenal switch (DS) compared to the Roux-en-Y gastric bypass (RGB), however prior studies were often not well controlled. This study compares similar weight patients undergoing either the DS or RGB. METHODS: A retrospective comparison of RGB and DS performed at a single center between 2/02-12/04 on patients of similar weight and BMI was done. Pre- and postoperative care was identical for all patients. RGB is performed with a 75cm biliopancreatic limb, a 100cm antecolic Roux limb, and a hand-sewn gastroenterostomy to a 20cc linear gastric pouch. DS is performed with a 250cm alimentary limb, a 100cm common channel, and a retrocolic hand-sewn duodenoenterostomy. RESULTS: Preoperative weight and BMI were similar in both groups. At 1 year postop, BMI was 28.0±4.6kg/m2 for RGB and 26.8 ±3.8kg/m2 for DS (p=NS), %EWL was 73.7±16.0% for RGB and 77.8±12.2% for DS (p=NS), and weight lost was 110±32lbs for RGB and 118±20lbs for DS (p<0.05). At 1 year postop, 4/66 (6.1%) RGB patients were still obese with a BMI >35, versus 2/30 (6.7%) DS patients (p=NS). CONCLUSIONS:Patients undergoing DS had similar outcome in terms of %EWL and weight lost compared to RGB patients, but DS had significantly higher rates of reoperation and complication.
| N | Age (yrs) | Male (%) | Preop Wt (lbs) | Preop BMI (kg/m2) | 1 Year BMI (kg/m2) | EBL (cc) | OR time (min) | |
| RGB | 255 | 44.0±9.5 | 34 (13%) | 284±49 | 46.1±4.8 | 28.0±4.6 | 57±45 | 142±32* |
| DS | 68 | 41.8±7.7 | 5 (7%) | 283±37 | 46.1±5.0 | 26.8±3.8 | 98±43 | 228±44 |
| Follow-up (days) | LOS (days) | Non-Op Readmits | Reops | Deaths | No. of Patients with Complications | |||
| Minor | Major | Total | ||||||
| RGB | 462±237 | 3.9±1.4 | 4 (1.6%)* | 15 (5.9%)* | 0 | 21 (8.2%)* | 14 (5.5%)* | 35 (13.7%)* |
| DS | 601±227 | 4.1±2.2 | 7 (10.3%) | 9 (13.2%) | 0 | 8 (11.8%) | 11(16.2%) | 19 (27.8%) |
500 Cummings Center
+1 978-927-8330
+1 978-524-0498
