[Biliopancreatic bypass in the treatment of severe obesity: long-term clinical, nutritional and metabolic evaluation].

Biliopancreatic bypass surgery leads to considerable weight loss and the stabilisation over time of the newly acquired body weight. The aim of this study was to evaluate the long-term clinical and nutritional conditions of patients undergoing this operation. Thirty subjects who had undergone biliopancreatic bypass surgery (7 males and 23 females) aged between 20 and 55 years old, with body mass indexes between 35 and 80, were examined at yearly intervals (maximum follow-up 5 years). Tha following parameters were evaluated at each control: body weight, presence of collateral effects, support therapy, main hematochemical parameters, nutritional behavior and calorie intake. All patients recorded a significant reduction in body weight with a mean weight loss of 28% during the first year; these values were confirmed during the second year, whereas body weight tended to stabilise in the long-term. Laboratory data showed a significant reduction in triglycerides, cholesterol, glycemia in all patients; sideropenic anemia appeared in 50% of patients. Mean daily calorie intake was 2,200 kcal/day, broken down as follows: glucides 50%, lipids 33%, proteins 17%. The main collateral effects reported were: diarrhea, vomit, flatulence, onset of food intolerances. The following support therapies were used: iron in 90% of cases, calcium in 60% and 30% of patients also underwent surgery. In conclusion, biliopancreatic bypass surgery enables a significant weight loss to be achieved together with an improved glycolipid status without leading to nutritional deficiencies.(ABSTRACT TRUNCATED AT 250 WORDS)