Skogar ML, et al. – Authors performed a comparison of outcomes in patients with super obesity after Roux–en–Y gastric bypass (RYGB) and duodenal switch (BPD/DS) using the Bariatric Analysis and Reporting Outcome System (BAROS) and a local questionnaire for gastrointestinal symptoms. Patients with super obesity indicated a better weight reduction and metabolic control with BPD/DS, but at the cost of higher adverse event rate, compared to patients operated with RYGB.

Methods

• Authors performed a retrospective mail survey including 211 patients, 98 RYGB and 113 BPD/DS, with a mean follow-up time of 4 years for both groups.
• Similar gender distribution, age, and comorbidities were evident.
• They documented weight loss, changes in comorbidities, quality of life (QoL), and adverse events, as well as, gastrointestinal symptoms.

Results

• Despite higher preoperative BMI (56 ± 6.7 vs. 52 ± 4.0 kg/m², p < 0.01), lower postoperative BMI was evident in the BPD/DS group (31 ± 5.5 vs. 36 ± 7.1 kg/m², p < 0.01).
• BPD/DS seemed associated with superior effect on diabetes; otherwise, both groups were similar regarding reduction in comorbidities.
• Observations revealed no difference in QoL.
• RYGB seemed associated with lower adverse event incidence rate (14 vs. 27%).
• Overall, the BPD/DS group indicated a superior BAROS score (4.7 ± 2.0 vs. 4.0 ± 2.1, p < 0.05).
• More common occurence of dumping was observed after RYGB (p < 0.01), while reflux, diarrhea, fecal incontinence, and problems with malodorous flatus were more common after BPD/DS (all p < 0.05).
• Similar frequency of nausea/vomiting and abdominal pain was observed.