Weight loss and effect on co-morbidities in the long-term after duodenal switch and gastric bypass : a population-based cohort study

• Background: Unsatisfactory weight loss is common after bariatric surgery in patients with super obesity (body mass index [BMI] >= 50 kg/m(2)). Unfortunately, this group of patients is increasing worldwide.Objective: The aim of this study was to compare long-term weight loss and effect on co-morbidities after duodenal switch (DS) and gastric bypass (RYGB) in super-obese patients.Setting: University hospital, Sweden, national cohort.Methods: This observational population-based cohort-study of primary DS and RYGB (BMI >= 48 kg/m(2)) in Sweden from 2007 to 2017 used data from 4 national registers. Baseline characteristics were used for propensity score matching (1 DS:4 RYGB). Weight loss was analyzed up until 5 years after surgery. Medication for diabetes, hypertension, dyslipidemia, depression, and pain were analyzed up until 10 years after surgery.Results: The study population consisted of 333 DS and 1332 RYGB, with 60.7% females averaging 38.5 years old and BMI 55.0 kg/m(2) at baseline. DS resulted in a lower BMI at 5 years compared with RYGB, 32.2 +/- 5.5 and 37.8 +/- 7.3, respectively, (P < .01). DS reduced prevalence of diabetes and hypertension more than RYGB, while reduction in dyslipidemia was similar for both groups, during the 10-year follow-up. Both groups increased their use of antidepressants and a maintained a high use of opioids.Conclusion: This study indicates that super-obese patients have more favorable outcomes regarding weight loss and effect on diabetes and hypertension, after DS compared with RYGB. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Duodenal switch

Gastric bypass

Bariatric surgery

Weight loss

Obesity

Super obesity

Long-term results

Diabetes

Hypertension

Dyslipidemia

Depression

Opioid

Publikations- och innehållstyp

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