The results of Hess–Marceau biliopancreatic diversion with duodenal switch and sleeve gastrectomy in treatment of patients with morbid obesity

The aim of the study was to improve the results of surgical treatment in patients with morbid obesity by comparative assessing the results of Hess–Marceau biliopancreatic diversion with duodenal switch and sleeve gastrectomy. Materials and methods. The results of surgical treatment in 205 patients with morbid obesity who underwent sleeve gastrectomy (main group – 105 patients) or Hess–Marceau biliopancreatic diversion with duodenal switch (comparison group – 100 patients) were analyzed. The indicators of efficiency and safety of the abovementioned procedures were investigated. Results and discussion. Biliopancreatic diversion compared to sleeve gastrectomy provided more meaningful regression of body mass and obesityrelated diseases. However, the late morbidity rate in the comparison group was 33% (mortality rate – 4%), in the main group – 16.2% (χ2=7.85, Р=0.005). In the main group no deaths were recorded. Conclusions. The optimal primary bariatric procedure for the majority of patients is laparoscopic sleeve gastrectomy. The use of biliopancreatic diversion by Hess–Marceau as both in primary and revisional bariatric surgery is justified only in some patients in cases of combination of morbid obesity with severe type 2 diabetes mellitus.