Biliopancreatic Diversion with Duodenal Switch in the Elderly: Long-Term Results of a Matched-Control Study.

TitleBiliopancreatic Diversion with Duodenal Switch in the Elderly: Long-Term Results of a Matched-Control Study.
Publication TypeJournal Article
Year of Publication2016
AuteursMichaud, A, Marchand, GB, Nadeau, M, Lebel, S, Hould, F-S, Marceau, S, Lescelleur, O, Biron, S, Tchernof, A, Biertho, L
JournalObes Surg
Volume26
Issue2
Pagination350-60
Date Published2016 Feb
ISSN1708-0428
KeywordsAdult, Age Factors, Anastomosis, Surgical, Biliopancreatic Diversion, Case-Control Studies, Comorbidity, Duodenum, Female, Humans, Male, Middle Aged, Obesity, Morbid, Prevalence, Weight Loss
Abstract

BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective surgical approaches for the treatment of severe obesity.OBJECTIVE: The objective of this study is to compare perioperative complications and long-term results of open BPD-DS in elderly versus younger patients.METHODS: All patients aged 60 years and above who underwent a primary open BPD-DS in our center were selected (n = 105). Patients were matched 1:1 for sex, BMI, the presence of type 2 diabetes (T2DM), and year of surgery with a group of younger patients (aged ≤55 years).RESULTS: The mean age of the patients was 62.3 ± 2.0 vs. 40.4 ± 7.0 years (p ≤ 0.0001). Initial BMI and prevalence of T2DM were similar in both groups, at 50.9 kg/m(2) and 57%, respectively. Mean operative time (178.6 ± 46.7 vs. 162.5 ± 39.9 min, p = 0.01), hospital stay (10.2 ± 8.3 vs. 6.3 ± 1.5 days, p = 0.0001), and blood loss (593 ± 484 vs. 474 ± 241 ml, p = 0.05) were significantly higher in elderly patients. No difference in 30-day mortality rate was observed (0.9% in each group). There was no significant difference in major complication rate (16.2 vs. 8.6%, p = 0.09). At a mean follow-up of 7.1 ± 4.1 years, excess weight loss (67.6 ± 19.2 vs. 72.7 ± 20.7%, p = 0.06) and BMI (32.2 ± 5.7 vs. 30.8 ± 6.6 kg/m(2), p = 0.15) were not significantly different. No significant difference was observed between the two groups for the resolution of T2DM (p = 0.53) and obstructive sleep apnea (p = 0.44).CONCLUSIONS: Open BPD-DS is associated with similar long-term benefits in elderly and younger patients, in terms of weight loss and resolution or improvement of obesity-related comorbidities. Perioperative complications might be more frequent in the elderly population, but this was not associated with increased mortality.

DOI10.1007/s11695-015-1772-x
Alternate JournalObes Surg
PubMed ID26130180