Duodenal switch for morbid obesity

http://www.ncbi.nlm.nih.gov/pubmed/22405918

Am J Surg. 2012 Mar 8. [Epub ahead of print]

The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.

Nelson D, Porta R, Blair K, Carter P, Martin M.

Source

Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.

Abstract

BACKGROUND:

Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.

METHODS:

Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.

RESULTS:

A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.

CONCLUSIONS:

The DS procedure resulted in a superior reduction in cardiovascular and proinflammatory risk markers compared with GB and SG.