Cirugía Bariátrica

Comparación de manga gástrica vertical versus derivación biliopancreática  Comparison of vertical sleeve gastrectomy versus biliopancreatic diversion.  Sucandy I, Titano J, Bonanni F, Antanavicius G.  North Am J Med Sci [serial online] 2014 [cited 2014 Jan 27];6:35-8. Abstract Background: Vertical sleeve gastrectomy (VSG) was originally performed as the first-stage of biliopancreatic diversion with duodenal switch (BPD/DS) for superobesity as a strategy to reduce perioperative complications and morbidity. VSG is now considered a definitive procedure because of its technical simplicity and promising outcomes. Aims: To analyze the outcomes of laparoscopic VSG and to compare them with those of single-stage laparoscopic BPD/DS. Materials and Methods: A retrospective review of 200 consecutive patients who underwent VSG and BPD/DS between 2008 and 2011. Results: A total of 100 patients underwent laparoscopic VSG and 100 patients underwent laparoscopic BPD/DS. The patients in VSG group were older, but gender distribution and body mass index were comparable. Mean operative time for VSG was significantly shorter compared with that of BPD/DS. A single patient in each groups required open conversion. Staple line leak (n = 1) and intraluminal hemorrhage into the newly-created sleeve (n = 1) occurred in the BPD/DS group. Mean length of stay was shorter after VSG (3.1 vs. 3.9 days). At 6 months postoperatively, excess weight loss between the two groups revealed statistically significant difference, favoring BPD/DS. Conclusions: Despite promising outcomes and technical simplicity of VSG, BPD/DS provides significantly superior excess weight loss in morbidly obese patients. Keywords: Biliopancreatic diversion, biliopancreatic diversion, comparison, sleeve gastrectomy  http://www.najms.org/text.asp?2014/6/1/35/125865  http://www.najms.org/downloadpdf.asp?issn=1947-2714;year=2014;volume=6;issue=1;spage=35;epage=38;aulast=Sucandy;type=2     La derivación biliopancreática es más efectiva de la manga gástrica  Biliopancreatic diversion is more effective than sleeve gastrectomy.  Nanni G.  North Am J Med Sci [serial online] 2014 [cited 2014 Jan 27];6:39-40.  The study by Sucandy and coworkers [1] deals with a frequently neglected topic in bariatric surgery, related to the importance of the results in terms of weight loss in the selection of the procedure to be performed. The recently developed and highly fashionable sleeve gastrectomy (SG) is compared to the time honored and successful biliopancreatic diversion in the duodenal switch version (BPD-DS).. The article presents two series each of 100 obese patients submitted to SG or BPD-DS. A significant percentage of patients have been lost to the follow-up; nevertheless data show that BPD-DS attains greater success in terms of body mass index (BMI) reduction 18 months after surgery. The effects of malabsorption appear very early, with differences between the two procedures already evident after 6 months. The great diffusion of SG is mainly due to its technical ease and to its "natural" ending in patients with inadequate weight loss: being SG the first step of BPD-DS, an eventual failure can be corrected performing the duodenal switch. http://www.najms.org/text.asp?2014/6/1/39/125866   http://www.najms.org/downloadpdf.asp?issn=1947-2714;year=2014;volume=6;issue=1;spage=39;epage=40;aulast=Nanni;type=2 Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org