BILIOPANCREATIC DIVERSION FOR TREATMENT OF MORBID-OBESITY - EXPERIENCE IN 50 CASES

Background: Biliopancreatic diversion (BPD) by Scopinaro's method is a n operation advocated by some surgeons as an effective treatment for m orbid obesity. Methods: Between February 1995 and April 1997 we perfor med BPD by Scopinaro's method on 50 patients with morbid obesity (23 m ales), average age 41.4 years (range 20-63 years), average body weight 135.08 kg (range 89-256 kg), mean body mass index (BMI) 50.65 kg/m(2) (range 37.01-81.56 kg/m(2)). Results: In all cases a gradual decrease in weight was obtained [mean BMI at 1 month: 44.8 kg/m(2), at 6 month s (31 patients): 35.09 kg/m(2), at 1 year (23 patients): 31.36 kg/m(2) , at 18 months (14 patients): 29.89 kg/m(2) and at 2 years (5 patients ): 29.27 kg/m(2)]. At the same time a significant improvement in the p athological conditions associated with morbid obesity was observed. Th e patients were able to suspend oral antihypertensive and antidiabetic therapy as these parameters spontaneously returned to normal values b y the sixth postoperative month; all cases showed a marked reduction i n hypercholesterolemia and hypertriglyceridemia. Postoperative complic ations were: one death (2%) on the third day due to heart failure; two late intestinal occlusions (4%); one acute dilatation of the stomach (2%); one peritonitis caused by early dehiscence of the anastomosis (2 %); five anastomotic ulcers (10%); two cases of protein malnutrition ( 4%). Conclusions: BPD by Scopinaro's method is a bariatric procedure w hich is technically complex. However is it safe and reproducible and i t induces a substantial weight loss. (C) 1998 Rapid Science Ltd.