A matched cohort study of laparoscopic biliopancreatic diversion with duodenal switch and sleeve gastrectomy performed by one surgeon

作者：Polega James R^*; Barreto Tyler W; Kemmeter Kimberly D; Koehler Tracy J; Davis Alan T; Kemmeter Paul R

来源：Surgery for Obesity and Related Diseases, 2017, 13(3): 411-414.

DOI：10.1016/j.soard.2016.10.023

• Biliopancreatic diversion
• Duodenal switch
• Laparoscopic
• Sleeve gastrectomy

Setting: 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)
Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.

• 出版日期2017-3