Biliopancreatic diversion for treatment of morbid obesity: Experience in 180 consecutive cases

Background: Biliopancreatic diversion (BPD) by Scopinaro's method is used b y many as a surgical treatment for morbid obesity. The authors present thei r results in 180 consecutive cases. Method: Between June 1995 and May 1998, the authors performed BPD by Scopin aro's method on 180 patients (36 men) with morbid obesity, mean age 35.8 ye ars (range 18-58 years), mean body mass index (BMI) 48.8 kg/m(2) (range 35- 66 kg/m(2)). Results: In all cases, a gradual decrease in weight was obtained: the mean BMI at 1 month was 40.3 kg/m(2), at 6 months 34 kg/m(2), at 1 years 32 kg/m (2), at 18 months 30.2 kg/m(2), and at 36 months 28.8 kg/m(2). At the same time a significant improvement in the pathologic conditions associated with morbid obesity was observed. Postoperative complications were two duodenum blowout syndromes requiring prolonged intensive care, and an 18% rate of i ncisional hernias. Conversion to normal small bowel continuity was necessar y in three cases. Protein malnutrition developed in 2 patients (1.1%), in 1 patient coinciding with addiction to cocaine. One patient could not psycho logically accept the physical changes and requested conversion. Anastomotic ulceration was seen in 11% of the patients. Operation for late obstruction occurred in 2 patients. There was no mortality. Conclusions: Although BPD by Scopinaro's method is technically complex, it is safe and effective.