Laparoscopic restoration of gastrointestinal continuity after duodenal switch

Abstract

Biliopancreatic diversion (BPD) with duodenal switch (DS) for morbid obesity was first performed by Hess and Hess [ [1] Hess D.S. Hess D.W. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998; 8: 267-282 Crossref PubMed Scopus (656) Google Scholar ] in 1988. BPD-DS incorporates two distinct procedures: the BPD, which had been well established by Scopinaro et al. [ [2] Scopinaro N. Gianetta E. Civalleri D. et al. Biliopancreatic bypass for obesity: initial experience in man. Br J Surg. 1979; 66: 618-620 Crossref PubMed Scopus (417) Google Scholar ] in 1976 and the DS, established by DeMeester et al. [ [3] DeMeester T.R. Fuchs K.H. Ball C.S. Albertucci M. Smyrk T.C. Marcus J.N. Experimental and clinical results with proximal end-to-end duodeno-jejunostomy for pathologic duodenogastric reflux. Ann Surg. 1987; 206: 414-424 Crossref PubMed Scopus (173) Google Scholar ]. At 10 years, Hess et al. [ [4] Hess D.S. Hess D.W. Oakley R.S. The biliopancreatic diversion with the duodenal switch: results beyond 10 years. Obes Surg. 2005; 15: 408-416 Crossref PubMed Scopus (213) Google Scholar ] reported excellent long-term results in terms of weight loss, with a percentage of excess weight loss (%EWL) of 75% in 92% of the patients followed up, in addition to high patient satisfaction and low complication rates. Similar long-term results were also reported by Marceau et al. [ [5] Marceau P. Biron S. Hould F.S. et al. Duodenal switch: long-term results. Obes Surg. 2007; 11: 1421-1430 Crossref Scopus (162) Google Scholar ] with a %EWL of 73% ± 19% in 1356 living patients after a mean follow-up of 7.3 ± 3.7 years.