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    Weight loss surgery: Duodenal switch better than vertical banded gastroplasty


    Posted by .(JavaScript must be enabled to view this email address)
    Monday, July 10, 2006 2:43 am Email this article
    For morbidly obese patients, the duodenal switch procedure is more successful than vertical banded gastroplasty according to a study from Spain. Weight Loss

    Losing at least half of their excess weight: 88% with duodenal switch vs 55% with vertical banded gastroplasty

    Seven out of every eight patients (87.5 percent) who underwent duodenal switch lost at least half of their excess weight compared to slightly more than half (55 percent) of those who underwent vertical banded gastroplasty.

     

    Dietary Restrictions

    Could eat a normal diet after weight loss: 80% with duodenal switch vs 0% with vertical banded gastroplasty

    Another advantage of the duodenal switch, according to the paper, was that of the patients who lost at least half their excess weight, none of the patients who underwent vertical banded gastroplasty could eat a normal diet whereas four-out-of-five patients (80 percent) who underwent duodenal switch had no dietary restrictions.

     

    Reoperation Rate

    Reoperation: 2% with duodenal switch vs 9% with vertical banded gastroplasty

    The reoperation rate was also lower with duodenal switch than with vertical banded gastroplasty.

    Only one patient (2 percent) who underwent duodenal switch—1 out of 49 patients—required reoperation, whereas 9.4 percent of those who underwent vertical banded gastroplasty—8 out of 85—required reoperation.

     

    Duodenal switch

    Duodenal switch has fewer complications

    Duodenal switch is a modification to biliopancreatic diversion which has fewer complications than the original procedure according to a paper by Pannala (2006).

    Here is what he says about it:

    “Biliopancreatic diversion, a second-generation malabsorptive procedure developed by Scopinaro et al [1979], combines a subtotal gastrectomy, a gastroileostomy, and an ileoileostomy. Further refinements of this procedure have included a duodenal switch modification [1993], which has reportedly fewer complications. Presently, these procedures are popular in Canada and Italy while gaining increasing popularity in the USA.” (Pannala et al, 2006)

    REFERENCE

    Perez N, Serra C, Baltasar A, Ferri L, Bou R, Bengochea M. [Comparative results between vertical ringed gastroplasty and duodenal switch in morbid obesity]. Cir Esp. 2006 May, 79(5):283-88.

    AUTHOR’S CONTACT INFORMATION

    N. Perez
    Servicio de Cirugia
    Hospital Virgen de los Lirios
    Alcoy, Alicante
    Espana (Spain)
    .(JavaScript must be enabled to view this email address)

    REFERENCE

    Pannala R, Kidd M, Modlin I. Surgery for obesity: Panacea or pandora’s box? Dig Surg. 2006 Apr 20, 23(1-2):1-11.

    AUTHOR’S CONTACT INFORMATION

    R. Pannala
    Department of Internal Medicine
    Bridgeport Hospital/Yale University
    Bridgeport, Conn
    USA

    Irvin M. Modlin, MD, PhD, FRCS
    Yale University School of Medicine
    POB 208062
    New Haven, CT 06520
    USA
    +1 203 785 5429 phone
    +1 203 737 4067 fax
    .(JavaScript must be enabled to view this email address)

     

    Articles on the same subject can be found here:


    COMMENTS

    On Sep 26, 2006 at 11:08 am Maurice wrote:

    . . . . .

    I'm very interested in this procedure. I live in Florida, near Orlando. Can you reccomend a doctor for me. I'm willing to travel. What are the associated cost? Recovery time?

    On Sep 27, 2006 at 8:19 am Larry Hobbs wrote:

    . . . . .

    Maurice,

    I don't know of one, but I'll see what I can find and post it here.

    On Sep 27, 2006 at 9:13 am Larry Hobbs wrote:

    . . . . .

    Maurice,

    A list of surgeons who do this procedure can be found here:

    http://www.duodenalswitch.com/surgeons/surgeons.html

    ------

    I would suggest you ask the following questions.

    1. How many patients have you done this procedure on?

    This is extremely important. Research shows that the more experience a surgeon has, the fewer the complications.

    -------

    2. How many of your patients have died within a year of the procedure?

    Hopefully none, but if someone says "only 4 or 5", whereas others say none, I would avoid the ones who have had patients die.

    -------

    If you can talk to the nurse or secretary in the doctors office, I would ask this:

    3. Beside your doctor, what three other surgeons are most well known for this procedure?

    If you ask enough people in the field, the same names will keep coming up. People in the business know who is the best.

    -------

    I would probably also have a tendency to favor a surgeon associated with a University.

    I have been told that doctors associated with Universities tend to be better informed.

    For example, there is:

    William B. Inabnet, MD in New York at Columbia University.

    Daniel M. Herron, MD in New York who is at the Mount Sinai School of Medicine.

    Peter Crookes, MD, Howard Kaufman, MD, and Lelan Sillin, MD in Los Angeles at the University of Southern California (USC).

    Please feel free to share your comments about this article.


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