de Luis D A, Pacheco D, Izaola O, Romero A, Marcos J L, Pelaz J, Barrera A, Cabezas G, Terroba M C, Cuellar L, Anta A
Institute of Endocrinology and Nutrition, Medical School Unit of Investigation, Surgical Department, Hospital Rio Hortega, University of Valladolid, 47130 Valladolid, Spain.
Obes Surg. 2005 Jun-Jul;15(6):799-802. doi: 10.1381/0960892054222740.
Scopinaro biliopancreatic diversion (BPD) for morbid obesity results in significant longterm weight loss and reduction or resolution of obesity-associated co-morbidities. The aim of our work was to describe the early results after BPD.
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 present the data of basal and early visits (2 and 4 months).
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 clinical 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 incisional hernia (21.1%), anastomotic leak (5.2%), wound infection (15.7%), intra-abdominal infection (5.2%), and intestinal obstruction (5.2%).
BPD showed early effectiveness in weight loss and co-morbidity improvement. Calorie, protein, oligoelement and vitamin dietary intakes were below recommendations, so that strict multidisciplinary follow-up and supplementation to prevent or treat nutritional deficiencies are mandatory.
斯科皮纳罗胆胰转流术（BPD）用于治疗病态肥胖可带来显著的长期体重减轻，并减少或消除与肥胖相关的合并症。我们这项工作的目的是描述BPD术后的早期结果。
2001年12月至2004年12月，59例病态肥胖患者（BMI>40）接受了开放性BPD手术。我们分析了连续的19例随访时间超过4个月的患者。我们展示了基础访视和早期访视（2个月和4个月）的数据。
2个月时初始超重百分比降低（IEW%L）为5.2%，4个月时为13.7%。每次访视时血糖、胆固醇、甘油三酯水平和血压均有所改善。所有参数与基础值均有显著差异。3例患者患有睡眠呼吸暂停综合征，到4个月时，2例患者通过夜间持续气道正压通气（CPAP）得以缓解。6例患者（31.5%）白蛋白<2.5 g/dl，但无营养不良的临床表现。4个月时总热量摄入（857±79.8千卡/天）和蛋白质摄入（59.8±23克/天）较低，食物中多种维生素和微量元素的摄入量也较低。该系列中无死亡病例。术后早期并发症包括切口疝（21.1%）、吻合口漏（5.2%）、伤口感染（15.7%）、腹腔内感染（5.2%）和肠梗阻（5.2%）。
BPD在减重和改善合并症方面显示出早期有效性。热量、蛋白质、微量元素和维生素的饮食摄入量低于推荐水平，因此必须进行严格的多学科随访和补充，以预防或治疗营养缺乏。
