CILIO PANCREATIC DIVERSION WITH PRESERVATION OF DUODENAL BULB AND TRANSITORY GASTROPLASTY IN THE TREATMENT OF SEVERE OBESITY. OUR EXPERIENCE

Abstract

We present our experience in malabsorbitive procedure in bariatric surgery based on Biliopancreatic Diversion (BPD) with transitory gastroplasty.

Since 1995 we operated on 74 patients with BPD coupled with gastroplasty wich is transitory due to the presence of a band in polidioxanone (PDS). The tecnique, proposed by Vassallo et al in 1992, involve the respect of the duodenal bulb (5 centimeter from the pylorous) making an endto-side duodeno-ileal isoperistaltic anastomosis.

The initial excess weight loss was satisfactory (69.8% ± 11.4% after 1 year) and it kept being stable during all the follow-up (75.2% ± 6.4% after 5 years). The mortality was absence. We didn’t observe ipoalbuminemia, diarrhea or halitosis in any patients. Only 1 patient (1.3%) developed an anastomotic ulcer. After 5 years follow-up we observed 2 cases (12.5%) of chronic hypochromic anemia and 1 case (6.2%) of hypocalcemia. We didn’t perform any restorative operation.

We consider this tecnique a good malabsortive procedure able to obtain a satisfactory and stable weight loss, with a low incidence of complications. Moreover it could be applied in patients previously treated by an ineffective gastroplasty.