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Malabsorptive bariatric procedures have a long history beginning with jejunoileal bypass, wich was first performed in 1950s. The biliopancreatic diversion (BPD) has gained more prominence in Europe since its introduction by Scopinaro in 1976. The BPD has been modified and popularized by Hess in the United States and Marceau in Canada to include a sleeve gastrectomy and duodenal switch in order to decrease the incidence of marginal ulceration and iron deficiency anemia. Moreover the common channel was lengthened to 100 cm to decrease the incidence of long-term malnutrition. More recently Vassallo and coll. introduced a BPD associated with a transitory vertical gastroplasty (TGR). Aim of this study is to compare the results after 2 years follow-up in 15 obese patients who underwent the classical Scopinaro’s BPD (group A) and 15 obese patients operated on BPD associated with TGR (group B).The mean preoperative BMI was 47.9 in the Group A and 48.6 in Group B. The BMI trend was after 6 , 12 and 24 months: 39.1, 37.2, 33.1 in Group A and 37.3, 35.5, 31.4 in Group B. We observed in BPD+TGR one case of acute pancreatitis and 3 case of gastric paralysis in group A. No mortality was registered. Patients treated by BPD+TGR had better results in terms of weight loss and metabolic complications.