Biliopancreatic Diversion for Treatment of Morbid Obesity: Experience in 180 Consecutive Cases

Background: Biliopancreatic diversion (BPD) by Scopinaro's method is used by many as a surgical treatment for morbid obesity. The authors present their results in 180 consecutive cases. Method: Between June 1995 and May 1998, the authors performed BPD by Scopinaro's method on 180 patients (36 men) with morbid obesity, mean age 35.8 years (range 18-58 years), mean body mass index (BMI) 48.8 kg/m2 (range 35-66 kg/m2). Results: In all cases, a gradual decrease in weight was obtained: the mean BMI at 1 month was 40.3 kg/m2, at 6 months 34 kg/m2, at 1 years 32 kg/m2, at 18 months 30.2 kg/m2, and at 36 months 28.8 kg/m2. At the same time a significant improvement in the pathologic conditions associated with morbid obesity was observed. Postoperative complications were two duodenum blowout syndromes requiring prolonged intensive care, and an 18% rate of incisional hernias. Conversion to normal small bowel continuity was necessary in three cases. Protein malnutrition developed in 2 patients (1.1%), in 1 patient coinciding with addiction to cocaine. One patient could not psychologically accept the physical changes and requested conversion. Anastomotic ulceration was seen in 11% of the patients. Operation for late obstruction occurred in 2 patients. There was no mortality. Conclusions: Although BPD by Scopinaro's method is technically complex, it is safe and effective.