Strain Gladys W, Torghabeh Mehyar H, Gagner Michel, Ebel Faith, Dakin Gregory F, Abelson Jonathan S, Connolly Daniel, Pomp Alfons
Department of Surgery, Weill Cornell Medical College, 525 E 68th St, New York, NY, 10065, USA.
Department of Surgery, Hopital du Sacre Coeur, Montreal, QC, Canada.
Obes Surg. 2017 Mar;27(3):787-794. doi: 10.1007/s11695-016-2371-1.
There is limited information on the multiple long-term effects of the biliopancreatic diversion with duodenal switch (BPD/DS).
Patients who consented to a BPD/DS from 1999 to 2010 were evaluated for weight change, complications, comorbidity resolution, body composition, quality of life, and depressive symptoms during visits at 1, 3,5, 7, and 9 years. Descriptive statistics, analysis of variance, and pair-wise comparisons were calculated for each of the five follow-up cohorts vs. the baseline cohort.
Between 1999 and 2010, 284 patients received a BPD/DS; 275 patients (69.8 % women) age 42.7 years, BMI 53.4 kg/m qualified for baseline analysis. Two hundred seventy-five patients were available in year 1; 275 patients in year 3; 273 patients in year 5; 259 patients in year 7; and 228 patients in year 9. Gender distribution was not different. BMI was 30.1 at 1 year and 32.0 at 9 years. Body fat was reduced to 26 % after 2 years. Complications requiring surgery were significant. Nutritional problems developed in 29.8 % of patients over the course of observation. The baseline Beck Depression Index (BDI) was 13.9 and 7.2 in year 1. Year 1 through 9 remained unchanged. There were significant positive changes in quality of life between baseline and year 1 for most domains. These positive changes were maintained for the follow-up cohorts. After surgery the resolution of comorbidities continued for the 9 years.
Weight loss during the first year was well maintained, resolving comorbidities and improving quality of life. Rates of surgical complications resemble other bariatric procedures. Long-term nutrient deficiencies are of concern.
关于胆胰转流十二指肠转位术（BPD/DS）的多种长期影响的信息有限。
对1999年至2010年期间同意接受BPD/DS手术的患者在第1、3、5、7和9年的随访中进行体重变化、并发症、合并症缓解情况、身体成分、生活质量和抑郁症状的评估。对五个随访队列中的每一个与基线队列进行描述性统计、方差分析和两两比较。
1999年至2010年期间，284例患者接受了BPD/DS手术；275例患者（69.8%为女性），年龄42.7岁，BMI为53.4kg/m²符合基线分析条件。第1年有275例患者；第3年有275例患者；第5年有273例患者；第7年有259例患者；第9年有228例患者。性别分布无差异。第1年BMI为30.1，第9年为32.0。2年后体脂降至26%。需要手术治疗的并发症较为显著。在观察过程中，29.8%的患者出现营养问题。基线贝克抑郁量表（BDI）评分为13.9，第1年为7.2。第1年至第9年保持不变。大多数领域在基线和第1年之间生活质量有显著的积极变化。这些积极变化在随访队列中得以维持。手术后合并症的缓解持续了9年。
第1年的体重减轻得到良好维持，合并症得到缓解，生活质量得到改善。手术并发症发生率与其他减肥手术相似。长期营养缺乏令人担忧。
