Skip to main content
SpringerLink
Log in

Laparoscopic Malabsorption Procedures: Controversies

  • Chapter
Minimally Invasive Bariatric Surgery

Abstract

Since Scopinaro published his landmark paper on biliopancreatic bypass for obesity in 1979, this operation, now more commonly known as biliopancreatic diversion (BPD), has been surrounded by controversy (1). It carries perceptions of being more dangerous to perform than other procedures and of having more severe metabolic sequelae. Many surgeons have thought that it should be reserved as a revisional procedure or used to advantage only in the super-obese. But surgeons who perform the operation point to its proven track record in maintaining weight loss, which they cite as the most cogent reason to use BPD as a primary bariatric operation. This dichotomy may be best summed up in a communication by Scopinaro in response to an algorithm for selecting bariatric procedures written by Buchwald (2). Buchwald described the BPD as being popular in Italy. Scopinaro (3) replied, “The BPD was conceived in Italy and is popular everywhere.”

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 249.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Scopinaro N, Gianette E, Civalleri D. Biliopancreatic bypass for obesity: II. Initial experiences in man. Br J Surg 1979; 66:618–620.

    Article  CAS  PubMed  Google Scholar 

  2. Buchwald H. A bariatric surgery algorithm. Obes Surg 2002;12(6):733–746.

    Article  PubMed  Google Scholar 

  3. Scopinaro N. Comments to presidential address: gastric bypass and biliopancreatic diversion operations. Obes Surg 2002;12:881–883.

    Article  PubMed  Google Scholar 

  4. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg 1998;22(9):936–946.

    Article  CAS  PubMed  Google Scholar 

  5. Marceau P, Hould F-S, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998;22:947–954.

    Article  CAS  PubMed  Google Scholar 

  6. Sanchez-Cabezudo DC, Larrad JA. Analysis of weight loss with the biliopancreatic diversion of Larrad: absolute failures or relative successes? Obes Surg 2002;12(2):253.

    Article  Google Scholar 

  7. Slater GH, Duncombe J, Fielding GA. Poor weight loss after revised bilio-pancreatic diversion for laparoscopic gastric band failure: an analysis of 18 cases. Surg Obes Relat Dis 2005;1:573–579.

    Article  PubMed  Google Scholar 

  8. Anthone GA, Lord RNV, DeMeester TR, et al. The Duodenal Switch Operation for the Treatment of Morbid Obesity: A 10-Year Experience. Presented at American Society for Bariatric Surgery (ASBS) Essentials in Bariatric Surgery, Course, Boston, MA: 2003.

    Google Scholar 

  9. Goodney PP, Siewers AE, Stukel TA, et al. Is Surgery getting safer? National trends in operative mortality. J Am Coll Surg 2002;195(2):219–227.

    Article  PubMed  Google Scholar 

  10. Grossmann EM, Longo WE, Virgo KS. Morbidity and mortality of gastrectomy for cancer in Department of Veterans Affairs Medical Centers. Surgery 2002;131(5):484–490.

    Article  PubMed  Google Scholar 

  11. O’Brien PE, Dixon JB. Weight loss and early and late complications-the international experience. Am J Surg 2002;184(6B):42S–45S.

    Article  PubMed  Google Scholar 

  12. Angrisani L, Alkilani M, Basso N, et al. Laparoscopic Italian experience with the Lap Band. Obes Surg 2001;11(3):307–310.

    Article  CAS  PubMed  Google Scholar 

  13. Weiner R, Blanco-Eugert R, Weiner S, et al. Outcome after laparoscopic adjustable gastric banding—8 years’ experience. Obes Surg 2003;13(3):427–434.

    Article  CAS  PubMed  Google Scholar 

  14. Sarr MG, Felty CL, Hilmer DM, et al. Technical and practical considerations involved in operations on patients weighing more than 270kg. Arch Surg 1995;130(1):L102–105.

    Article  CAS  PubMed  Google Scholar 

  15. Paiva D, Bernardes L, Suretti L. Laparoscopic biliopancreatic diversion: technique and initial results. Obes Surg 2002; 12(3):358–361.

    Article  PubMed  Google Scholar 

  16. Scopinaro N, Marinari GM, Camerini G. Laparoscopic standard biliopancreatic diversion: technique and preliminary results. Obes Surg 2002;12(3):362–365.

    Article  PubMed  Google Scholar 

  17. Dolan K, Hatzifotis M, Newbury L, Lowe N, Fielding G. A clinical and nutritional comparison of biliopancreatic diversion with and without duodenal switch. Ann Surg 2004;240: 51–56.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Baltasar A, Bou R, Miro J, et al. Laparoscopic biliopancreatic diversion with duodenal switch: technique and initial experience. Obes Surg 2002;12:245–248.

    Article  CAS  PubMed  Google Scholar 

  19. Ren C, Patterson E, Gagner M. Early results of laparoscopic bilio-pancreatic diversion with duodenal switch. Obes Surg 2000;10:514–523.

    Article  CAS  PubMed  Google Scholar 

  20. Oliak D, Ballantyne GH, Davies RJ. Short-term results of laparoscopic gastric bypass in patients with BMI ≥60. Obes Surg 2002;12:643–647.

    Article  PubMed  Google Scholar 

  21. Fernandez AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to mortality and leak. Surg Endosc 2003;17(suppl).

    Google Scholar 

  22. Stucki A, Grob JP, Chapuis G, et al. Biliopancreatic bypass and disorders of iron absorption. Schweiz Med Wochenschr 1991;121(50):1894–1896.

    CAS  PubMed  Google Scholar 

  23. Clare MW. An analysis of 37 reversals on 504 biliopancreatic surgeries over 12 years. Obes Surg 1993;3:169–173.

    Article  PubMed  Google Scholar 

  24. Hess DW, Hess DS. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–282.

    Article  CAS  PubMed  Google Scholar 

  25. Jones KB. Quo Vadis? Obes Surg 2002;12:617–622.

    Article  PubMed  Google Scholar 

  26. Brolin RE, Gorman RC, Milgrim LM, et al. Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Int J Obes 1991;15:661–668.

    CAS  PubMed  Google Scholar 

  27. Scopinaro N. Comments to presidential address: gastric bypass and biliopancreatic diversion operations. Obes Surg 2002;12:881–884.

    Article  PubMed  Google Scholar 

  28. Newbury L, Dolan K, Hatzifotis M, et al. Calcium, vitamin D, alkaline phosphatase and parathyroid hormone following pancreatico-biliary diversion. Obes Surg 2003;13: 893–895.

    Article  PubMed  Google Scholar 

  29. Slater GH, Ren CJ, Siegel N, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg 2004; 8:48–55.

    Article  PubMed  Google Scholar 

  30. Brolin RE, Gorman JH, Gorman RC, et al. Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study. Arch Surg 1998;133:740–744.

    CAS  PubMed  Google Scholar 

  31. Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg 1999;9(2):150–154.

    Article  CAS  PubMed  Google Scholar 

  32. Chu CA, Gagner M, Quinn T, et al. Two-stage laparoscopic biliopancreatic diversion with duodenal switch: an alternative approach to super-super morbid obesity. Surg Endosc 2002;16:S187–S231.

    Article  Google Scholar 

  33. Anthone G, Lord R, Almogy G, et al. Gastrectomy alone as surgical treatment for morbid and super-morbid obesity. Obes Surg 2003;13:209–210.

    Google Scholar 

  34. Dixon JB, O’Brien P. Selecting the optimal patient for lapband placement. Am J Surg 2002;184:175–205.

    Google Scholar 

  35. Fielding G A. Laparoscopic adjustable gastric banding for massive super obesity BMI >60. Surg Endosc 2003;17:1541–1545.

    Article  CAS  PubMed  Google Scholar 

  36. Gibbs K, White N, Vaimakis S, et al. Laparoscopic gastric bypass in the “massive superobese.” Obes Surg 2003;13: 221–222.

    Google Scholar 

  37. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232:515–529.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg 2002;235:640–647.

    Article  PubMed Central  PubMed  Google Scholar 

  39. De Csepel J, Quinn T, Pomp A, Gagner M. Conversion to a laparoscopic biliopancreatic diversion with a duodenal switch for a failed laparoscopic adjustable silicone gastric banding. J Laparoendosc Adv Surg Tech A 2002;12(4):237–240.

    Article  PubMed  Google Scholar 

  40. Gagner M, Steffen R, Biertho L, et al. Laparoscopic adjustable gastric banding with duodenal switch for morbid obesity: technique and preliminary results. Obes Surg 2003;13:444–449.

    Article  PubMed  Google Scholar 

  41. Yashkov YI, Oppel TA, Shishlo LA, et al. Improvement of weight loss and metabolic effects of vertical banded gastroplasty by an added duodenal switch procedure. Obes Surg 2001;11:635–639.

    Article  CAS  PubMed  Google Scholar 

  42. Dolan K, Fielding G. Bilio pancreatic diversion following failure of laparoscopic adjustable gastric banding. Surg Endosc 2004;18:60–63.

    Article  CAS  PubMed  Google Scholar 

  43. Dolan K, Hatzifotis M, Newbury L, Fielding G. A comparison of laparoscopic adjustable gastric banding and biliopancreatic diversion in superobesity. Obes Surg 2004;14: 165–169.

    Article  PubMed  Google Scholar 

  44. Sugerman HJ, Kellum JM, Engle K, et al. Randomized trial of proximal and distal gastric bypass in the super-obese: early results [abstract]. Presented at the 4th International Symposium on Obesity Surgery, London, UK, August 24, 1989.

    Google Scholar 

  45. Fobi M, Lee H, Igwe D, et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg 2001;11:190–195.

    Article  CAS  PubMed  Google Scholar 

  46. Fox SR, Fox KS, Oh KH. The gastric bypass for failed bariatric surgical procedures. Obes Surg 1996;6:145–150.

    Article  PubMed  Google Scholar 

  47. Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg 1992;21:387–395.

    Article  Google Scholar 

  48. Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Obes Surg 2002;12:551–558.

    Article  PubMed  Google Scholar 

  49. Lemmens L. Biliopancreatic diversion as a redo operation for failed restrictive gastric surgery. Obes Surg 2002;12: 479.

    Google Scholar 

  50. Rabkin RA, Rabkin JM, Metcalf B, et al. Laparoscopic technique for performing duodenal switch with gastric reduction. Obes Surg 2003;13:263–268.

    Article  PubMed  Google Scholar 

  51. Jones KB. The superiority of the left subcostal incision compared to mid-line incisions in surgery for morbid obesity. Obes Surg 1993;3:201–205.

    Article  PubMed  Google Scholar 

  52. Strauss RS, Bradley LJ, Brolin RE. Gastric bypass surgery in adolescents with morbid obesity. J Pediatr 2000;138:499–504.

    Article  Google Scholar 

  53. Sugerman HJ, Sugerman EL, DeMaria EJ, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg 2003;7:102–108.

    Article  PubMed  Google Scholar 

  54. Endres JE, Wittgrove AC. Laparoscopic Roux-en-Y gastric bypass in adolescents. Obes Surg 2003;13:206.

    Google Scholar 

  55. Dolan K, Creighton L, Hopkins G, et al. Laparoscopic gastric banding for morbidly obese adolescents. Obes Surg 2003;13:101–104.

    Article  PubMed  Google Scholar 

  56. Breaux CW. Obesity surgery in children. Obes Surg 1995;5: 279–284.

    Article  PubMed  Google Scholar 

  57. Antal S, Levin H. Biliopancreatic diversion in Prader-Willi syndrome associated with obesity. Obes Surg 1996;6:58–62.

    Article  PubMed  Google Scholar 

  58. Marinari GM, Camerini G, Novelli GB, et al. Outcome of biliopancreatic diversion in subjects with Prader-Willi syndrome. Obes Surg 2001;11:491–495.

    Article  CAS  PubMed  Google Scholar 

  59. Grugni G, Guzzaloni G, Morabito F. Failure of biliopancreatic diversion in Prader-Willi syndrome. Obes Surg 2000; 10:179–181.

    Article  CAS  PubMed  Google Scholar 

  60. Gerrits EG, Ceulemans R, van Hee R, et al. Contraceptive treatment after biliopancreatic diversion needs consensus. Obes Surg 2003;13:378–382.

    Article  PubMed  Google Scholar 

  61. Friedman D, Cuneo S, Valenzano M, et al. Pregnancies in an 18-year follow-up after biliopancreatic diversion. Obes Surg 1995;5:308–313.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, New York University Program for Surgical Weight Loss, New York, NY, USA

    George A. Fielding MD (Associate Professor)

Authors
  1. George A. Fielding MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Lerner College of Medicine, USA

    Philip R. Schauer MD (Professor of Surgery) (Professor of Surgery)

  2. Advanced Laparoscopic and Bariatric Surgery, Bariatric and Metabolic Institute The Cleveland Clinic Foundation, Cleveland, OH, 44195, USA

    Philip R. Schauer MD (Professor of Surgery) (Professor of Surgery)

  3. Department of Surgery Health Sciences Center, University of Virginia Health System, Charlottesville, VA, 22908, USA

    Bruce D. Schirmer MD (Stephen H. Watts Professor of Surgery) (Stephen H. Watts Professor of Surgery)

  4. Advanced Laparoscopic and Bariatric Surgery, Department of Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Stacy A. Brethauer MD (Staff Surgeon) (Staff Surgeon)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Fielding, G.A. (2007). Laparoscopic Malabsorption Procedures: Controversies. In: Schauer, P.R., Schirmer, B.D., Brethauer, S.A. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68062-0_41

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-68062-0_41

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-68058-3

  • Online ISBN: 978-0-387-68062-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation