Duodenal Switch May Be Best for Super-Obese Patients

Study shows duodenal switch produces greater likelihood of successful weight loss than gastric bypass

MONDAY, Sept. 25 (HealthDay News) -- A duodenal switch may be a better weight-loss procedure than the standard gastric bypass for patients with a body mass index of 50 or greater, according to a report published online Sept. 22 in Annals of Surgery.

Vivek N. Prachand, M.D., and colleagues from the University of Chicago compared weight loss, decrease in body mass index (BMI) and percentage of excess body weight loss (percent EBWL) in all patients with a BMI of 50 or above who underwent duodenal switch and gastric bypass at their institution between August 2002 and October 2005.

The investigators found that the percent EBWL loss was greatest for the 198 patients who underwent duodenal switch, reaching a maximum of 71.9 percent at 18 months. The 152 gastric bypass patients reached maximum percent EBWL of 62.8 percent at 18 months. Total weight loss and decrease in BMI were also greatest for the duodenal switch group and the procedure had the greatest likelihood of producing successful weight loss.

"Safely obtained significant and sustained excess weight loss is the key goal of surgical treatment of super-obesity," the authors write. "Our direct comparison of duodenal switch to Roux-en-Y gastric bypass demonstrates that the duodenal switch provides superior weight loss in the super-obese compared with gastric bypass."

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