BILIOPANCREATIC DIVERSION PRESERVING THE STOMACH AND PYLORUS IN THE TREATMENT OF HYPERCHOLESTEROLEMIA AND DIABETES TYPE-II - RESULTS IN THEFIRST 10 CASES

Background: Besides weight loss Scopinaro's operation produces correct ion of hypercholesterolemia and noninsulin dependent diabetes mellitus in all patients who suffer from these conditions. These results encou raged us to perform biliopancreatic diversion (BPD) without gastric re section, thus preserving the functions of the stomach and pylorus in m oderately overweight patients with hypercholesterolemia associated wit h diabetes type II and hypertriglyceridemia. Methods: Between March 19 96 and July 1997 we performed BPD without gastric resection on 10 mode rately overweight patients [mean body mass index (BMI) = 33.2 kg/m(2)] . All patients had suffered from hypercholesterolemia and hypertriglyc eridemia for more than 5 years. Ten patients suffered from diabetes ty pe II; four of them had had insulin treatment or oral anti-diabetic ag ents; the other patients all had hyperglycaemia in the fasted state an d diabetes confirmed by preoperative oral glucose tolerance test (OGTT ). Five patients suffered from hypertension. Results: In all patients, cholesterol and triglyceride levels returned to normal within the fir st postoperative month. Glycemia also stabilized at normal values in n ine patients within the early weeks after surgery. One patient who too k 70 U of insulin reduced his daily intake to 35 U 2 months postoperat ively. In all patients blood pressure returned to normal. Weight loss was predictably slight (10-15 kg). Conclusions: Our experience with th e procedure found that this new method seems to be as effective in con trolling lipidic metabolism and diabetes II as the original version of BPD. As expected, weight loss is only moderate, so that the modified BPD is not suitable for very obese patients. (C) 1998 Rapid Science Lt d.