BILIOPANCREATIC DIVERSION WITH TRANSITORY GASTROPLASTY PRESERVING DUODENAL BULB - 3 YEARS EXPERIENCE

Background: The authors have performed 521 bariatric surgery operation s (319 restrictive procedures and 202 malabsorptive procedures). Metho ds: During the last few years we have introduced an evolution of bilio pancreatic diversion (BPD): BPD with transitory gastroplasty, preservi ng the duodenal bulb (53 cases). From a technical point of view, the o peration consists of a BPD, coupled with a gastroplasty which is trans itory due to the use of a polydioxanone (PDS) band. In the last few ca ses, instead of a VBG (with PDS band) in order to make the operation c ompletely reversible without any suture on the stomach, we made a gast ric pouch by banding with PDS calibrated with the same tube as for the Lap-band (20 cc). We maintained completely the duodenal bulb (5 cm fr om the pylorus), making an end-to-side duodeno-ileal isoperistaltic an astomosis. Results: With this anastomosis, only 2% of patients develop ed an anastomotic ulcer. With this new procedure, results have been go od in terms of weight loss (similar to that of BPD-AHS) and in nutriti onal complications. No patient has had hypoalbuminemia, diarrhea or ha litosis. Conclusion: BPD with temporary gastric restriction has provid ed satisfactory results.