Polega James R, Barreto Tyler W, Kemmeter Kimberly D, Koehler Tracy J, Davis Alan T, Kemmeter Paul R
Michigan State University College of Human Medicine, East Lansing, Michigan.
Grand Rapids Medical Education Partners /Michigan State University Family Medicine Residency, East Lansing, Michigan.
Surg Obes Relat Dis. 2017 Mar;13(3):411-414. doi: 10.1016/j.soard.2016.10.023. Epub 2016 Oct 31.
Spectrum Blodgett and Mercy Health St. Mary's hospitals in Grand Rapids, Michigan OBJECTIVE: To compare the 30-day outcomes of laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) to laparoscopic sleeve gastrectomy (SG).
Laparoscopic BPD/DS has been shown to be superior to SG in terms of excess weight loss. Despite this superiority, BPD/DS accounts for a small percentage of all metabolic surgeries due partly to the perception that BPD/DS has a higher complication rate than SG.
Retrospective review of all patients who underwent BPD/DS or SG from January 2008 to August 2014 by 1 surgeon was completed. These patients were used to construct cohorts matched via propensity score matching and compared by surgical type. Data collected included patient demographic characteristics; hospital length of stay (LOS); and 30-day rates of leak, bleed, reoperation, readmission, and mortality.
Of the 741 patients who underwent BPD/DS or SG, 2 cohorts of 167 patients each were matched for age, sex, and BMI. LOS was longer in the BPD/DS cohort (2.5±.9 days versus 2.1±.7 days, P<.001). There were no significant differences between the groups in relation to 30-day postoperative rates of leak (.3% versus .6%, P>.99), bleed (0% versus .3%, P>.99), reoperation (1.2% versus .6%, P>.99), or readmission (3% versus 1.2%, P = .45). There were no mortalities.
After matching for age, sex, and BMI, BPD/DS found no significant differences from SG with regard to 30-day postoperative rates of leak, bleed, reoperation, readmission, or mortality.
密歇根州大急流城的斯pectrum Blodgett医院和梅西健康圣玛丽医院
比较腹腔镜胆胰分流十二指肠转位术（BPD/DS）与腹腔镜袖状胃切除术（SG）的30天治疗效果。
腹腔镜BPD/DS在减重方面已被证明优于SG。尽管有这种优势，但BPD/DS在所有代谢手术中所占比例较小，部分原因是人们认为BPD/DS的并发症发生率高于SG。
对2008年1月至2014年8月间由1名外科医生实施BPD/DS或SG手术的所有患者进行回顾性研究。这些患者用于构建通过倾向得分匹配的队列，并按手术类型进行比较。收集的数据包括患者人口统计学特征、住院时间（LOS）以及30天的渗漏、出血、再次手术、再入院和死亡率。
在接受BPD/DS或SG手术的741例患者中，每组167例患者按年龄、性别和BMI进行匹配。BPD/DS队列的住院时间更长（2.5±0.9天对2.1±0.7天，P<0.001）。两组在术后30天的渗漏率（0.3%对0.6%，P>0.99）、出血率（0%对0.3%，P>0.99）、再次手术率（1.2%对0.6%，P>0.99）或再入院率（3%对1.2%，P = 0.45）方面无显著差异。无死亡病例。
在按年龄、性别和BMI匹配后，BPD/DS与SG在术后30天的渗漏、出血、再次手术、再入院或死亡率方面无显著差异。
