To investigate the feasibility and safety of laparoscopic biliopancreatic diversion with duodenal switch(BPD/DS) preliminarily in the treatment of Chinese patients with obesity.

The clinical data of eleven patients with obesity treated with BPD/DS from September 2019 to January 2020 were analyzed retrospectively.We analyzed each index at one year after operation. Statistical analysis were performed by using SPSS 22.0 software. Measurement data were expressed as (±s). They were examined by using paired t test (Normality data) or Mann-Whitney U test (skewed data), as appropriate. A P value of <0.05 was considered as statistically significant difference.

All of 11 patients underwent successfully BPD/DS without conversion to laparotomy or perioperative death. The follow-up rate at 1 year after surgery was 81.8% (9/11). The results in the first postoperative year were as follows: The body weight and body mass index were (77.3±15.8) kg and (25.6±5.3) kg/m², which decreased significantly than those of before operation respectively (P<0.05). The systolic blood pressure and diastolic blood pressure were (119.3±17.2) mmHg and (76.1±13.4) mmHg, which decreased significantly than those before operation respectively (P<0.05), and the remission rate of hypertension was 77.7% (7/9). The remission rate of hyperuricemia was 66.7% (4/6). The remission rate of type 2 diabetes mellitus 1 year after operation was 100.0% (4/4). The remission rate of total cholesterol, triglycerides, and low-density lipoprotein over the normal upper limit before operation were 100.0% (4/4), 100.0% (3/3), and 100.0% (6/6) at 1 year after surgery. There were five complications in total: 1 case of postoperative intraperitoneal hemorrhage, 1 case of duodenal-ileal anastomotic leakage, 1 case of intestinal obstruction, 1 case of chronic anemia (Hb: 97.0g/L) and 1 case of chronic hepatic parenchyma damage. The level of zinc, vitamin E, folic acid, and albumin of the 9 patients who were followed up in the first postoperative year decreased significantly than those before operation (P<0.05), and their percentages below the normal range were 44.4% (4/9), 55.5% (5/9), 0% (0/9) and 22.2% (2/9). The serum chlorine level of 9 patients at 1 year after operation increased significantly than those before operation respectively (P<0.05).

Although laparoscopic biliopancreatic diversion with duodenal switch is considered as giving a significant curative effect on obesity and its-related metabolic diseases, the complication rate of this operation is relatively high. Therefore, it needs to be carefully to carry out this procedure because the feasibility and safety of BPD/DS are not good.