Chang Alvin, Pina Luis, Harris Donovan, Wood Craig, Obradovic Vladan, Parker David M
Division of Bariatric and Foregut Surgery and the Obesity Institute, Geisinger Health System, Danville, Pennsylvania.
Division of Bariatric and Foregut Surgery and the Obesity Institute, Geisinger Health System, Danville, Pennsylvania.
Surg Obes Relat Dis. 2025 May;21(5):548-553. doi: 10.1016/j.soard.2024.11.004. Epub 2024 Dec 2.
Patients with body mass index (BMI) ≥50 have more obesity-associated medical problems and often require more aggressive surgical management. Few single-institution comparative studies have been published examining this specific population.
The study aims to compare the weight loss and diabetes remission effects of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion with duodenal switch (BPD/DS).
Rural academic tertiary care center.
We conducted a retrospective cohort study using prospectively collected data. All patients with a BMI ≥50 who underwent an SG, RYGB, and BPD/DS were included. Comparative analysis was performed for complications, readmission rates, weight loss, and diabetes remission.
Excess weight loss at 3 years was 40.1% for SG, 54.1% for RYGB, and 67.4% for BPD/DS, with BPD/DS performing significantly better (P < .001). Complete diabetes remission at 5 years was 29% for SG, 61% for RYGB, and 79% for BPD/DS. BPD/DS had significantly longer operative times (P < .001) and rates of minor complications (P = .02).
BPD/DS achieved superior sustained weight loss and diabetes remission compared with RYGB and SG.
体重指数（BMI）≥50的患者有更多与肥胖相关的医学问题，通常需要更积极的手术治疗。很少有单机构比较研究发表，探讨这一特定人群。
本研究旨在比较袖状胃切除术（SG）、Roux-en-Y胃旁路术（RYGB）和胆胰分流十二指肠转位术（BPD/DS）的减重和糖尿病缓解效果。
农村学术三级医疗中心。
我们使用前瞻性收集的数据进行了一项回顾性队列研究。纳入所有BMI≥50且接受了SG、RYGB和BPD/DS的患者。对并发症、再入院率、体重减轻和糖尿病缓解情况进行了比较分析。
SG在3年时的超重减轻率为40.1%，RYGB为54.1%，BPD/DS为67.4%，BPD/DS的效果显著更好（P < .001）。SG在5年时的糖尿病完全缓解率为29%，RYGB为61%，BPD/DS为79%。BPD/DS的手术时间显著更长（P < .001），轻微并发症发生率更高（P = .02）。
与RYGB和SG相比，BPD/DS在持续减重和糖尿病缓解方面取得了更好的效果。
