Preliminary results of the duodenal switch.

BACKGROUND

The duodenal switch (DS), as a modification of the bilio-pancreatic diversion (BPD), is a 'complex' hybrid operation.

METHODS

Sixty patients were operated on during the last 3 years.

RESULTS

Two patients died early (3.3%); two late deaths occurred at 4 and 7 months, one due to liver failure and the other due to malnutrition and refeeding syndrome (3.57%); three patients required conversions (5.3%). The two early deaths and all the patients who required conversions had a previous vertical banded gastroplasty. Eleven patients had minor liver abnormalities corrected with medications, and one patient had severe diarrhea for more than a year. Eleven female patients have iron deficiency anemia that requires parenteral supplementation. Mean percent excess weight loss was 86% at 2.5 years.

CONCLUSIONS

The DS has been, in our experience, an unsafe operation with unacceptably high operative and postoperative mortality. The conversion rate is acceptable. Weight loss, quality of food intake and life have been excellent. Inadequate follow-up can be dangerous if patients fail to report for regular visits.