Laparoscopic Biliopancreatic Diversion: Technique and Initial Results

Abstract

BPD may be performed by laparoscopy without changes in the original technique or in the early results.

SAGES guideline for clinical application of laparoscopic bariatric surgery

“…Firstly, because the details of the resection and reconstruction are the same, long-term outcomes are likely to be similar. Indeed, at 1 and 3 years follow-up, weight loss is similar to that achieved by open surgery [133,134]. Laparoscopic BPD has reduced hospital stay and complications, mainly due to a lower rate of wound infections and dehiscence [127].…”

Clinical application of laparoscopic bariatric surgery: an evidence-based review

“…First, because the details of the resection and reconstruction are the same, long-term outcomes are likely to be similar. Indeed, at follow-up periods of 1 and 3 years, weight loss is similar to Guidelines for preoperative preparation • A psychological evaluation is commonly part of the preoperative workup for bariatric patients (level 3) • Treated psychopathology does not preclude the benefits of bariatric surgery (level 2) • Preoperative weight loss may be useful to reduce liver volume and improve access for laparoscopic bariatric procedures (level 2, grade B), but mandated preoperative weight loss does not affect postoperative weight loss or comorbidity improvements (level 1) that achieved by open surgery [133,134]. Laparoscopic BPD has reduced hospital stay and complications, mainly due to a lower rate of wound infections and dehiscence [127].…”

“…The 30-day mortality of early laparoscopic BPD series ranges from 2.6% to 7.6% [134,147]. Major complications, which occur in up to 25% of cases, may include early occurrence of anastomotic leak, duodenal stump leak, intraabdominal infection, hemorrhage, and venous thromboembolism [29,[147][148][149][150], or later bowel obstruction, incarceration, or stricture [151].…”

“…Case series and systematic reviews put early mortality rates after laparoscopic AGB at 0.05-0.4% [21,209], compared with 0.5-1.1% for laparoscopic RGB [180], 0.5-1.0% for open RGB [21,22], 1.1% [21] for open BPD, and 2.5-7.6% for laparoscopic BPD [134,147,148]. Regarding relative morbidity rates, comparative data are few.…”

Optimal management of the morbidly obese patient SAGES appropriateness conference statement

“…Reports of the laparoscopic approach to BPD are limited to a few small case series [12]. Intestinal reconstruction mimics the open approach, and early weight loss is similar.…”