Ballesteros-Pomar María D, González de Francisco Tomás, Urioste-Fondo Ana, González-Herraez Luis, Calleja-Fernández Alicia, Vidal-Casariego Alfonso, Simó-Fernández Vicente, Cano-Rodríguez Isidoro
High Risk Obesity Unit, Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Altos de Nava s/n, Edificio Administrativo Ala Sur, 2ª planta, 24008, León, Spain.
Obes Surg. 2016 Jan;26(1):38-44. doi: 10.1007/s11695-015-1719-2.
Bariatric surgery is currently the treatment of choice for those patients with severe obesity, but the procedure of choice is not clearly established. We describe weight loss and nutritional parameters in severely obese patients after biliopancreatic diversion for 10 years of follow-up.
Patients were followed by the same multidisciplinary team, and data are shown for 10 years. Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, data regarding the evolution of obesity-related diseases, and nutritional parameters are reported.
Two hundred ninety-nine patients underwent biliopancreatic diversion, 76.1 % women, initial BMI 50.1 kg/m(2) (7.2). Weight loss was maintained throughout 10 years with EWL% around 65 % and EBMIL% around 70 %. More than 80 % of the patients showed EWL higher than 50 %. Blood pressure, glucose metabolism, and lipid profile clearly improved after surgery. Mean nutritional parameters remained within the normal range during follow-up. Protein malnutrition affected less than 4 % and anemia up to 16 %. Fat-soluble vitamin levels decreased along the time, with vitamin D deficiency in 61.5 % of patients. No significant differences were found either in nutritional parameters or weight loss regarding gastrectomy or gastric preservation, or common limb length longer or shorter than 55 cm
Biliopancreatic diversion is an effective surgical procedure in terms of weight loss, quality of life, and evolution of obesity-related diseases. Nutritional deficiencies are less frequent than feared for a malabsorptive procedure, but must be taken into account, especially for fat-soluble vitamins.
减肥手术目前是重度肥胖患者的首选治疗方法，但具体的手术方式尚未明确确立。我们描述了接受胆胰转流术的重度肥胖患者10年随访后的体重减轻情况和营养参数。
由同一多学科团队对患者进行随访，并展示了10年的数据。报告了减肥分析与报告结果系统（BAROS）问卷、肥胖相关疾病演变的数据以及营养参数。
299例患者接受了胆胰转流术，其中76.1%为女性，初始体重指数（BMI）为50.1kg/m²（7.2）。10年间体重持续减轻，体重减轻百分比（EWL%）约为65%，多余体重指数减少百分比（EBMIL%）约为70%。超过80%的患者EWL高于50%。术后血压、糖代谢和血脂状况明显改善。随访期间平均营养参数保持在正常范围内。蛋白质营养不良的发生率低于4%，贫血发生率高达16%。脂溶性维生素水平随时间下降，61.5%的患者存在维生素D缺乏。在营养参数或体重减轻方面；胃切除或保留胃；以及共同肠袢长度长于或短于55cm之间均未发现显著差异。
胆胰转流术在体重减轻、生活质量和肥胖相关疾病演变方面是一种有效的手术方法。营养缺乏的发生率低于对吸收不良手术的担忧，但必须予以考虑，尤其是脂溶性维生素。
