© FD-Communications Inc. Obesity Surgery, 15, 2005 799
Obesity Surgery, 15, 799-802
Background: Scopinaro biliopancreatic diversion
(BPD) for morbid obesity results in significant long-
term weight loss and reduction or resolution of obe-
sity-associated co-morbidities. The aim of our work
was to describe the early results after BPD.
Methods: 59 morbidly obese patients (BMI >40)
underwent open BPD from December 2001 to
December 2004. We analyzed a consecutive series of 19
patients who have been followed >4 months. We pres-
ent the data of basal and early visits (2 and 4 months).
Results: Initial excess weight percent loss (IEW%L)
was 5.2% at 2 months and 13.7% at 4 months.
Glycemia, cholesterol, triglyceride levels and blood
pressure improved at each visit. All parameters have
significant differences from the basal values. 3
patients had sleep apnea syndrome, and overnight
CPAP was able to cease in 2 patients by 4 months. 6
patients (31.5%) had albumin <2.5 g/dl, without clini-
cal findings of malnutrition. Total calorie (857±79.8
cal/day) and protein (59.8±23 g/day) intakes at 4
months were low, with a low intake of multivitamins
and oligoelements from food. There was no mortality
in this series. Early postoperative morbidity was inci-
sional hernia (21.1%), anastomotic leak (5.2%), wound
infection (15.7%), intra-abdominal infection (5.2%),
and intestinal obstruction (5.2%).
Conclusion: BPD showed early effectiveness in
weight loss and co-morbidity improvement. Calorie,
protein, oligoelement and vitamin dietary intakes
were below recommendations, so that strict multidis-
ciplinary follow-up and supplementation to prevent or
treat nutritional deficiencies are mandatory.
Key words: Morbid obesity, bariatric surgery, biliopancre-
atic diversion, early surgical results
Introduction
The prevalence of massive obesity is rising. Obesity
is associated with insulin resistance, which is a
major threat to adult health, and is believed to
underlie type 2 diabetes and cardiovascular disease.
1
In Spain, 0.5% of the population is morbidly obese
(0.7% of women and 0.4% of men).
2
Bariatric surgery
is the only effective long-term treatment for morbid
obesity, reducing or resolving the co-morbidities.
The biliopancreatic diversion (BPD) of
Scopinaro
3,4
is a mixed and complex operation that
has shown the best long-term results in weight loss.
BPD is considered to be a very good bariatric oper-
ation. As the complexity increases in bariatric oper-
ations, the effectiveness also increases, but the risk
of side-effects and potential complications likewise
may increase. A good knowledge of early follow-up,
and potential complications is important. The aim of
this study was to describe early results in morbidly
obese patients after BPD.
Subjects and Methods
Subjects
A total of of 59 morbidly obese patients (BMI >40)
have been operated upon from December 2001 to
December 2004. We analyzed a consecutive series of
19 patients who have been followed-up for >4
months, after open BPD by the Scopinaro technique.
The BPD consisted of a 200-cm alimentary limb
and a 50-cm common limb. Follow-up visits were car-
Early Clinical and Surgical Results of
Biliopancreatic Diversion
D. A. de Luis; D. Pacheco; O. Izaola; A. Romero; J. L. Marcos; J. Pelaz;
A. Barrera; G. Cabezas; M. C. Terroba; L. Cuellar; A. Anta
Institute of Endocrinology and Nutrition, Medical School Unit of Investigation, Surgical
Department, and Endocrinology Department, Hospital Rio Hortega, University of Valladolid,
Valladolid, Spain
Reprint requests to: Dr. D. A. de Luis, Associate Professor of
Nutrition, Executive Director of Institute of Endocrinology and
Nutrition, Medical School, Valladolid University, C/Los perales
16, Simancas 47130, Valladolid, Spain.
E-mail: dadluis@yahoo.es