A309 - COMPARATIVE RESULTS OF BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH AND TRANSIT BIPARTITION IN THE TREATMENT OF SUPEROBESITY

Abstract

Background: Transit bipartition (TBP) was compared with biliopancreatic diversion with duodenal switch (BPD-DS) it replaced early 2017 for patients whose initial body mass index (BMI) was ≥ 50 kg/m2. Sixty three consecutive primary BPT were compared to the 63 most recent primary BPD-DS. TBP used the same landmarks as BPD-DS: sleeve gastrectomy over a 50 Fr bougie, 250 cm distal ileum alimentary channel sutured to the gastric antrum with a 100 cm common channel. Unlike the BPD-DS, the duodenum was not transected to allow the food to pass through the 250 cm alimentary limb or the rest of the small bowel. 9-month follow-up was available for 24 of the TBPs and 62 of the BPD-DS. Although not heavier BPD-DS patients had a higher BMI. The main difference concerned the side effects with 50% and 78% of the TBP patients having 1 and 2 bowel movements respectively. After BPD-DS these figures were 10% and 32%. While no TBP patient had an albumin < 35 g/L, this occured for 12 of the 62 BPD-DS and 55% of the BPD-DS had a prealbumin below the normal value of 200 mg/L while this was observed in 13% of the 23 TBPs. 6 BPD-DS patients had a surgical revision/correction because of protein manutrition. In patients with BMI ≥ 50, transit bipartition is a quicker procedure without an impact on the complication rate. The most benefits appear to be on side effects and malnutrition.