François-Charles Malo1,2, Andréanne Marion3, Antoine Rioux3, Stéfane Lebel4, Frédéric Hould4, François Julien4, Simon Marceau4, Odette Lescelleur4, Annie Lafortune4, Léonie Bouvet-Bouchard4, Laurent Biertho4. 1. Department of surgery, Centre hospitalier universitaire de Sherbrooke - Université de Sherbrooke, Sherbrooke, Québec, Canada. francois-charles.malo@usherbrooke.ca. 2. Department of surgery, Institut universitaire de cardiologie et pneumologie de Québec - Université Laval, Québec, Canada. francois-charles.malo@usherbrooke.ca. 3. Department of surgery, Centre hospitalier universitaire de Sherbrooke - Université de Sherbrooke, Sherbrooke, Québec, Canada. 4. Department of surgery, Institut universitaire de cardiologie et pneumologie de Québec - Université Laval, Québec, Canada.
Abstract
PURPOSE: The effectiveness of the standard biliopancreatic diversion with duodenal switch (BPD/DS) in terms of weight loss has been demonstrated. Increasing the strict alimentary limb length while maintaining the length of the common channel could lead to similar weight loss while reducing side effects. MATERIALS AND METHODS: The objective was to evaluate the effect of increasing the strict alimentary limb length on weight loss, comorbidities, nutritional deficiencies, and quality of life 2 years after surgery, compared with standard BPD/DS. An exploratory randomized, double-blind study evaluated the results of LADS at 2 years in comparison with the standard BPD/DS. Common channel was kept at 100 cm in both groups while alimentary limb was created at 100 cm from Treitz angle in the LADS group and at 150 cm total in the BPD/DS group. RESULTS:Twenty patients were recruited from May 2013 to June 2015. Mean percentage of excess weight loss was statistically significantly lower in the LADS group at 24 months (81.6 ± 6.6% in the LADS group and 97.1 ± 11.1% in the BPD/DS group (p = 0.001). No significant difference regarding the rate of remission of comorbidities was noted. Mean calcium, vitamin D, hemoglobin, zinc, and copper levels were statistically lower in the BPD/DS group. Quality of life was significantly improved in both groups, with no statistically significant difference between the two groups. CONCLUSIONS: At 24 months, weight loss was lower in the LADS group. However, no difference was observed in the improvement in quality of life. LADS technique was discontinued following this study. TRIAL REGISTRATION: ClinicalTrial.gov Ref. NCT03097926.
RCT Entities:
PURPOSE: The effectiveness of the standard biliopancreatic diversion with duodenal switch (BPD/DS) in terms of weight loss has been demonstrated. Increasing the strict alimentary limb length while maintaining the length of the common channel could lead to similar weight loss while reducing side effects. MATERIALS AND METHODS: The objective was to evaluate the effect of increasing the strict alimentary limb length on weight loss, comorbidities, nutritional deficiencies, and quality of life 2 years after surgery, compared with standard BPD/DS. An exploratory randomized, double-blind study evaluated the results of LADS at 2 years in comparison with the standard BPD/DS. Common channel was kept at 100 cm in both groups while alimentary limb was created at 100 cm from Treitz angle in the LADS group and at 150 cm total in the BPD/DS group. RESULTS: Twenty patients were recruited from May 2013 to June 2015. Mean percentage of excess weight loss was statistically significantly lower in the LADS group at 24 months (81.6 ± 6.6% in the LADS group and 97.1 ± 11.1% in the BPD/DS group (p = 0.001). No significant difference regarding the rate of remission of comorbidities was noted. Mean calcium, vitamin D, hemoglobin, zinc, and copper levels were statistically lower in the BPD/DS group. Quality of life was significantly improved in both groups, with no statistically significant difference between the two groups. CONCLUSIONS: At 24 months, weight loss was lower in the LADS group. However, no difference was observed in the improvement in quality of life. LADS technique was discontinued following this study. TRIAL REGISTRATION: ClinicalTrial.gov Ref. NCT03097926.
Authors: Blaire Anderson; Richdeep S Gill; Christopher J de Gara; Shahzeer Karmali; Michel Gagner Journal: Gastroenterol Res Pract Date: 2013-11-21 Impact factor: 2.260