Pulkesh Bhatia, MD1, Steven Cheung, MD1, Thomas Kang1, Spencer Gantz1, Pradeep Pallati1, Armour Forse2, Kalyana Nandipati1. 1CREIGHTON UNIVERSITY MEDICAL CENTER, 2DOCTORS HOSPITAL AT RENAISSANCE HEALTH SYSTEM
Background: The resolution of comorbid conditions among the three most common bariatric procedures: sleeve gastrectomy, laparoscopic Roux-en-Y Gastrojejunostomy (LRNY), and biliopancreatic diversion with duodenal switch (BPD) in a single institution study has not been previously reported. This study aims to compare excess weight loss and co-morbidity resolution rates between these three procedures in a single center experience.
Methods: We identified 154 patients (who had at least one comorbid condition along with morbid obesity) from our retrospective database who had at least one year follow up. SPSS was used to analyze the data. ANOVA or the student t-test was used to identify significance between variables. The Chi square test was applied to assess categorical data. When the criteria for the above tests was not satisfied, we used Welch and Brown-Forsythe, Fisher or Mann-Whitney U test.
Results: The most common procedure performed was the LRNY (n=100) followed by the BPD (n=34) and sleeve gastrectomy (n=20). Patients with less than 1 year follow up were excluded from analysis. The majority of patients (75%) were women with an overall mean preoperative weight of 138.4 kgs (BMI 49.1). The average weight loss was 40.4 kg, which amounted to 42.4% in terms of excess weight loss. The diabetes mellitus (DM) resolution was statistically significantly higher in BPD (77.4%) compared to RNY (41.2%; p=0.001) and sleeve (37.5%, p=0.029). When comparing hypertension (HTN) improvement rates, these were found significantly higher in RNY (62%) compared to sleeve (36.8%; p < 0.05). When comparing BPD and sleeve; BPD was found to have statistically significant better rates with HTN resolution (48% vs 15.8%, p=0.02), DM resolution (77.4 % vs 37.5%, p= 0.029), GERD resolution (61.9% vs 26.7%, p= 0.03), OSA resolution (68.8 % vs 22.2% ,p=0.025) and HLD resolution (58.3 % vs 10% , p= 0.01); however complication (48.5% vs 10%, p=0.04) and reoperation rates (45.5% vs 5%, p= 0.002) were significantly higher in the BPD cohort compared to sleeve. No significant difference was found for the other co-morbidities analyzed between the bariatric procedures in our study cohort.
Conclusion: The resolution of comorbidities particularly diabetes mellitus was significantly higher in BPD patients comparison to other bariatric procedures, however this came at a much higher re operation and complication rates. The improvement in hypertension was also significantly higher after RNY compared to sleeve.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80773
Program Number: P495
Presentation Session: Poster (Non CME)
Presentation Type: Poster
sages_adbutler_leaderboard