Biliopancreatic diversion for treatment of morbid obesity: experience in 180 consecutive cases.

BACKGROUND

Biliopancreatic diversion (BPD) by Scopinaro's method is used by many as a surgical treatment for morbid obesity. The authors present their results in 180 consecutive cases.

METHOD

Between June 1995 and May 1998, the authors performed BPD by Scopinaro's method on 180 patients (36 men) with morbid obesity, mean age 35.8 years (range 18-58 years), mean body mass index (BMI) 48.8 kg/m2 (range 35-66 kg/m2).

RESULTS

In all cases, a gradual decrease in weight was obtained: the mean BMI at 1 month was 40.3 kg/m2, at 6 months 34 kg/m2, at 1 years 32 kg/m2, at 18 months 30.2 kg/m2, and at 36 months 28.8 kg/m2. At the same time a significant improvement in the pathologic conditions associated with morbid obesity was observed. Postoperative complications were two duodenum blowout syndromes requiring prolonged intensive care, and an 18% rate of incisional hernias. Conversion to normal small bowel continuity was necessary in three cases. Protein malnutrition developed in 2 patients (1.1%), in 1 patient coinciding with addiction to cocaine. One patient could not psychologically accept the physical changes and requested conversion. Anastomotic ulceration was seen in 11% of the patients. Operation for late obstruction occurred in 2 patients. There was no mortality.

CONCLUSIONS

Although BPD by Scopinaro's method is technically complex, it is safe and effective.