This review has been written by angelaj - a WLSInfo moderator - and is a brief interpretation of the research paper for your interest. 

Swedish Trial comparing RNY-V-DS

This paper looks at a study in Sweden of a controlled trial of 47 patients sorted into 2 groups - 23 to RNY and 24 to BPD/DS.  The trial wanted to compare the amount of weight lost, the experiences around surgery and the biochemical changes found up to 4 years post-op.  Biochemistry was collected pre-operatively and at 1 and 3 years.

They were allocated their surgery type whilst anaesthetised and on the operating table.  All had undergone the same pre-op preparation.  The trial was stopped after this number because patients wanted to choose their surgery type rather than be allocated blindly.

All patients had a BMI greater than 48 and less than about 62.  Equal numbers of men and women had the DS and 13 men and 10 women the RNY.

All operations were performed by the open method.  The surgical technique is described.

The operation time, recovery time and amount of morphine received after the op were all greater for DS than RNY.

Three patients needed re-operation, two DS and one RNY. One patient from the DS group died three weeks after surgery due to a pulmonary embolus although the post-op recovery was uneventful.

Five patients required surgery for incisional hernias following the open surgery.

At follow-up the reduction in BMI was marked 23 BMI-units in the DS group and 16 BMI-units in the RNY group. 40% of the RNY group failed to achieve 50% excess BMI-loss.  All participants were questioned about their lifestyle and any side-effects and the DS group reported more diarrhoea and smelly flatus than the RNY group, although both groups reported this.

No patients had low protein levels post-operatively, and lower fasting glucose and HbA1c levels were noted in the DS group.

The study concluded that BPD/DS provided greater weight loss and lower fasting glucose and HbA1c levels than the RNY.  This was without a great risk to nutrition and intolerable side effects.

 

Hedberg, J., Sundbom, M., Superior weight loss and lower

HbA1c three years after duodenal switch compared to Roux-en-Y gastric bypass - a

randomized controlled trial, Surgery for Obesity and Related Diseases(2012), doi:

10.1016/j.soard.2012.01.014.