Wang Lun, Zhang Zheng, Wang Zeyu, Jiang Tao
Department of Bariatric and Metabolic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Front Surg. 2023 Jan 6;9:934434. doi: 10.3389/fsurg.2022.934434. eCollection 2022.
Biliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric procedure used in the treatment of obesity and related metabolic disorders. However, to date, the data on BPD-DS among Chinese patients with obesity is completely lacking.
This is the first study to evaluate the safety and efficacy of BPD-DS in the treatment of Chinese patients with obesity.
Data from 12 patients undergoing BPD-DS between September 2019 and March 2020 were analyzed retrospectively to evaluate complications, weight loss, comorbidity resolution, and nutritional status.
All patients completed the 1-year follow-up. There was no conversion to laparotomy or death. Mean operative time was 257.08 ± 29.27 min. The median length of stay was 7 days (ranging from 4-38 days). Complications occurred in three patients. The 1-year body mass index was 25.13 ± 4.71 kg/m with a mean excess weight loss of 100.11 ± 33.29% and a mean total weight loss of 43.22 ± 7.71%. Remission was achieved in 100% (7/7 cases) for type 2 diabetes, in 83.3% (10/12 cases) for hypertension, and in 62.5% (5/8 cases) for hyperuricemia. At 1 year after BPD-DS, the prevalence of albumin deficiency was 16.7%, for iron deficiency was 16.7%, and for zinc deficiency was 50%. There were 8.3% of the patients who were anemic. High deficiency rates for vitamins were presented mainly in vitamin A and vitamin E: vitamin A in 58.3% of the patients and vitamin E in 50% of the patients. The prevalence of asymptomatic gallstones increased significantly from 0% preoperatively to 41.7% postoperatively.
BPD-DS had excellent weight loss and resolution of comorbidities among Chinese patients with obesity. However, high rates of nutritional deficiencies and complications were found after BPD-DS, especially for vitamin A and vitamin E.
胆胰转流十二指肠转位术(BPD-DS)是一种用于治疗肥胖症及相关代谢紊乱的减肥手术。然而,迄今为止,中国肥胖患者接受BPD-DS治疗的数据完全缺失。
这是第一项评估BPD-DS治疗中国肥胖患者安全性和有效性的研究。
回顾性分析2019年9月至2020年3月期间12例行BPD-DS手术患者的数据,以评估并发症、体重减轻、合并症缓解情况及营养状况。
所有患者均完成了1年随访。无中转开腹或死亡病例。平均手术时间为257.08±29.27分钟。中位住院时间为7天(4 - 38天)。3例患者出现并发症。1年时体重指数为25.13±4.71kg/m²,平均超重减轻率为100.11±33.29%,平均总体重减轻率为43.22±7.71%。2型糖尿病缓解率达100%(7/7例),高血压缓解率为83.3%(10/12例),高尿酸血症缓解率为62.5%(5/8例)。BPD-DS术后1年,白蛋白缺乏患病率为16.7%,铁缺乏患病率为16.7%,锌缺乏患病率为50%。8.3%的患者贫血。维生素缺乏率较高,主要集中在维生素A和维生素E:58.3%的患者维生素A缺乏,50%的患者维生素E缺乏。无症状胆结石患病率从术前的0%显著升至术后的41.7%。
BPD-DS在治疗中国肥胖患者方面具有出色的减重效果和合并症缓解情况。然而,BPD-DS术后发现营养缺乏和并发症发生率较高,尤其是维生素A和维生素E。