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- Title
Long-Term Experience with Duodenal Switch in Adolescents.
- Authors
Marceau, Picard; Marceau, Simon; Biron, Simon; Hould, Frederic-Simon; Lebel, Stefane; Lescelleur, Odette; Biertho, Laurent; Kral, John G.
- Abstract
Background: Severe or extreme obesity in children and adolescents is a progressive damaging disease, increasingly requiring surgical treatment. Timing and choice of operation are controversial. Method: In the last 16 years, we performed open biliopancreatic diversion with duodenal switch (DS) in 13 adolescents aged 15-17 years, who have been followed up for 2-16 years (mean, 10.6 years); three with Prader-Willi syndrome (PWS) are presented separately. Results: Among the ten non-PWS children (7 girls), no deaths or perioperative complications were reported, mean body mass index (BMI) decreased from 55.9 ± 14.0 to 28.8 ± 3.7 kg/m (% excess weight loss (EWL) = 82.1 ± 10.5%), and none have regained weight. All comorbidities were cured except asthma, which improved in one patient. There were two reoperations: one for intestinal obstruction and one for post-anastomotic ulcer. Glucose and lipid metabolism improved, while vitamin and mineral deficiencies were mild and rare. Five of the seven girls gave birth to 11 children, aged 2-12 years, two of whom are overweight but not severely obese. Neurodevelopment is age-appropriate in all 11 individuals. PWS children, aged 15-16 years, had postoperative respiratory and infectious complications necessitating hospitalizations of 13-22 days (versus 5.1 ± 1.2 days in non-PWS). Weight loss and comorbidity improvement lasted approximately 5 years, providing improved quality of life for patient and family. One PWS patient died from complications after reoperation for weight regain after 4 years. One was reoperated after 6 years and the third is considering reoperation 14 years after primary DS. Conclusion: The beneficial effects of DS in adolescents exceed the risks, even in the presence of PWS.
- Subjects
CHILDHOOD obesity; PANCREATIC surgery; DUODENUM surgery; PRADER-Willi syndrome; HOSPITAL care; ULCERS
- Publication
Obesity Surgery, 2010, Vol 20, Issue 12, p1609
- ISSN
0960-8923
- Publication type
Report
- DOI
10.1007/s11695-010-0262-4