More Weight Loss for Duodenal Switch Than Gastric Bypass

Greater reduction in weight, total and LDL cholesterol, but more adverse events

TUESDAY, Sept. 6 (HealthDay News) -- Duodenal switch results in greater reduction in body mass index (BMI) and total and low-density lipoprotein (LDL) cholesterol than gastric bypass, but has a higher rate of adverse events than gastric bypass, according to a study published in the Sept. 6 issue of the Annals of Internal Medicine.

Tongier T. Sǿvik, M.D., from Oslo University Hospital Aker in Norway, and colleagues investigated whether duodenal switch results in greater weight loss and more favorable improvements in cardiovascular risk factors and quality of life than gastric bypass in 58 individuals with a BMI between 50 and 60 kg/m². Change in the BMI after two years was the primary outcome. Anthropometric measures, concentrations of blood lipids, glucose, insulin, C-reactive protein (CRP), vitamins, health-related quality of life, and adverse events were secondary outcomes.

The investigators identified a mean reduction of 17.3 and 24.8 kg/m² in BMI after gastric bypass and duodenal switch, respectively. Duodenal switch resulted in greater reductions in total and LDL cholesterol, anthropometric measures, fat mass, and fat-free mass than gastric bypass. There were no between-group differences in the reduction in blood pressure and mean glucose, insulin, and CRP concentrations. Both groups showed improvements in most short form-36 health survey dimensional scores, with gastric bypass showing greater improvements in bodily pain. Only the duodenal switch group showed a reduction in vitamin A and 25-hydroxyvitamin D concentrations. Two years after the gastric bypass and duodenal switch, 32 and 62 percent of the participants, respectively, had adverse events. Adverse events related to malnutrition were only seen in patients who underwent duodenal switch.

"Duodenal switch surgery was associated with greater weight loss, greater reductions of total and low-density lipoprotein cholesterol concentrations, and more adverse events," the authors write.

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