Benefits and complications of the duodenal switch/biliopancreatic diversion compared to the Roux-en-Y gastric bypass

Robert B. Dorman, Nikolaus F. Rasmus, Benjamin J.S. Al-Haddad, Federico J. Serrot, Bridget M. Slusarek, Barbara K. Sampson, Henry Buchwald, Daniel B. Leslie, Sayeed Ikramuddin

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background: Despite providing superb excess weight loss and increased resolution of comorbid diseases, such as type 2 diabetes mellitus, compared to other bariatric procedures, the duodenal switch/ biliopancreatic diversion (DS/BD) has not gained widespread acceptance among patients and physicians. In this study, we investigated outcomes, symptoms and complications among postsurgical DS patients compared to RYGB patients. Methods: We used propensity scores to retrospectively match patients who underwent DS/BD between 2005 and 2010 to comparable Roux-en-Y gastric bypass (RYGB) patients. We then reviewed patient charts, and surveyed patients using the University of Minnesota Bariatric Surgery Outcomes Survey tool to track outcomes, comorbid illnesses and complications. Results: One hundred ninety consecutive patients underwent primary DS/BD between 2005 and 2010 at the University of Minnesota Medical Center. There were 178 patients available for follow-up (93.7%) who were matched to 139 RYGB patients. Type 2 diabetes, hypertension, and hyperlipidemia all significantly improved in each group. Improvements were significantly higher in the DS/BD group. Percent total weight loss was not different between groups. Loose stools and bloating symptoms were more frequently reported among DS/BD patients. With the exception of increased emergency department visits among DS/BD patients (P <.01), overall complication rates were not significantly different between DS/BD and RYGB. There was no difference in mortality rates between the groups. Conclusion: The DS/BD is a robust procedure that engenders both superior weight loss and improvement of major comorbidities. Complication and adverse event rates are similar to those of RYGB.

Original languageEnglish (US)
Pages (from-to)758-767
Number of pages10
JournalSurgery (United States)
Issue number4
StatePublished - Oct 2012

Bibliographical note

Funding Information:
Supported by research funds from the Department of Surgery, University of Minnesota .

Copyright 2013 Elsevier B.V., All rights reserved.


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