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Duodenal Switch Provides Superior Weight Loss in the Super-Obese (BMI ???50kg/m2) Compared With Gastric Bypass
Open accessAbstract
OBJECTIVES: Although weight loss following Roux-en-Y gastric bypass is acceptable in patients with preoperative body mass index (BMI) between 35 and 50 kg/m, results from several series demonstrate that failure rates approach 40% when BMI is > or =50 kg/m. Here we report the first large single institution series directly comparing weight-loss outcomes in super-obese patients following biliopancreatic diversion with duodenal switch (DS) and Roux-en-Y Gastric Bypass (RYGB). METHODS: All super-obese patients (BMI > or =50 kg/m) undergoing standardized laparoscopic and open DS and RYGB between August 2002 and October 2005 were identified from a prospective database. Two-sample t tests were used to compare weight loss, decrease in BMI, and percentage of excess body weight loss (% EBWL) after surgery. chi analysis was used to determine the rate of successful weight loss, defined as achieving at least 50% loss of excess body weight. RESULTS: A total of 350 super-obese patients underwent DS (n = 198) or RYGB (n = 152) with equal 30-day mortality (DS,1 of 198; RYGB, 0 of 152; P = not significant). The % EBWL at follow-up was greater for DS than RY (12 months, 64.1% vs. 55.9%; 18 months, 71. 9% vs. 62.8%; 24 months, 71.6% vs. 60.1%; 36 months, 68.9% vs. 54.9%; P < 0.05). Total weight loss and decrease in BMI were also statistically greater for the DS (data not shown). Importantly, the likelihood of successful weight loss (EBWL >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%; P < 0.05). CONCLUSIONS: Direct comparison of DS to RYGB demonstrates superior weight loss outcomes for DS.
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“There is no consensus concerning the best procedure for individuals with especially high BMI, but the efficacy and safety of MBS have been demonstrated in this population [86, 87].”
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Metadata
- Authors
- Prachand, V. N., DaVee, R. T., & Alverdy, J. C.
- Affiliations
- University of Chicago (US)
- ORCID
- Alverdy, John C.
- Venue
- Transactions of the ... Meeting of the American Surgical Association
- Published
- 2006
- Volume
- 124
- Issue
- 4
- Pages
- 276-284
- ISSN
- 0066-0833 (ISSN-L)
- PMC
- PMC1856567
- OpenAlex
- W2043071325
- Cited by
- 223
- References
- 39
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 10 · 2022: 6 · 2021: 7 · 2020: 11 · 2019: 9 · 2018: 6 · 2017: 9 · 2016: 10 · 2015: 12 · 2014: 15 · 2013: 13 · 2012: 21
- FWCI
- 15.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Transactions of the Meeting of the American Surgical Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- Roux-en-Y gastric bypass, super obesity, bariatric surgery, weight loss outcomes, excess weight loss, body mass index, biliopancreatic diversion, surgical failure rate
- MeSH terms
- Adolescent, Adult, Aged, Duodenum, Female, Humans, Male, Middle Aged, Obesity, Morbid, Retrospective Studies, Gastric Bypass, Weight Loss, Biliopancreatic Diversion
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