BILIOPANCREATIC DIVERSION WITH PYLORUS-PRESERVING TECHNIQUE - A NEW METHOD FOR THE SURGICAL CONTROL OF HYPERCHOLESTEROLEMIA AND DIABETES-II

Objective. The aim of this study was to evaluate the efficacy of bilio pancreatic diversion by Scopinaro's method, with a pylorus-preserving modification, in correcting hypercholesterolaemia and diabetes II not controllable by diet or medical treatment. Design. Besides weight loss , Scopinaro's operation produces a correction of hypercholesterolaemia and diabetes. These results encouraged us to perform BPD without gast ric resection, thus preserving the functions of the stomach and pyloru s in moderately overweight patients with hypercholesterolaemia and dia betes. Setting and patients. The pylorus-preserving technique has been performed on two patients suffering from severe hypercholesterolaemia and hyperglycaemia and who were not more than 30% overweight, at Clin ica Chirurgica and Chirurgia d'Urgenza Department, University of Sassa ri, Italy. Both patients had a six-month follow-up assessment. Main ou tcome measures. Examination of cholesterol and glycaemia levels after the operation, and the moderate weight loss. Intervention. The operati on is the same as Scopinaro's with regard to the length of intestine f orming the alimentary loop and the common tract. The difference lies i n the fact that instead of resecting the stomach and creating a gastro ileostomy, we resect the duodenum, and perform a duodenoileostomy. Res ults. In both patients the cholesterol and glycaemia levels had return ed to normal 1 month after the operation and are stable after six mont hs. Weight loss was only moderate. Conclusion. By the preliminary data on two patients treated with our modified technique this method seems to be as effective in controlling lipidic metabolism and diabetes II as the original version of biliopancreatic diversion.