Abstract
BackgroundPatients with Body Mass Index (BMI) ≥ 50 kg/m2 have more obesity-associated medical problems and often require more aggressive surgical management. Few single-institution comparative studies have been published examining this specific population. ObjectivesThe study aims to compare the weight loss and diabetes remission effects of Sleeve Gastrectomy (SG), Roux-en-Y Gastric Bypass (RYGB), and Biliopancreatic Diversion with Duodenal Switch (BPD/DS). SettingRural academic tertiary care center. MethodsWe conducted a retrospective cohort study using prospectively collected data. All patients with a BMI ≥ 50 kg/m2 who underwent a SG, RYGB, and BPD/DS were included. Comparative analysis was performed for complications, readmission rates, weight loss, and diabetes remission. ResultsExcess weight loss at 3 years was 40.1% for SG, 54.1% for RYGB, and 67.4% for BPD/DS, with BPD/DS performing significantly better (p<0.001). Complete diabetes remission at 5 years was 29% for SG, 61% for RYGB, and 79% for BPD/DS. BPD/DS had significantly longer operative times (p<0.001) and rates of minor complications (p=0.02). ConclusionsBPD/DS achieved superior sustained weight loss and diabetes remission compared to RYGB and SG.
Published Version
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