Obesity-related comorbidities resolved in a significant percentage of patients; hypertension was reduced from 49% to 9%, dyslipidemia from 16% to 0%, and glucose-intolerant or type 2 diabetes from 7% to 0%.
Twelve patients developed protein malnutrition at some point 1–10 years after surgery, and two patients had recurrent protein malnutrition. Those who experienced protein malnutrition after surgery had significantly higher initial body weight and BMI than did those who did not have malnutrition.
The incidence of protein malnutrition decreased steadily during the 30-year period of the study from 30% in the first few years to 2% in the last few years. The length of the common limb remained 50 cm, but as the surgeons gained experience, they adapted alimentary limb lengths to individual characteristics, and gastric sizes were not restricted to prevent protein malnutrition, Dr. Papadia said.
In a range of 4–18 years after BPD surgery, 18 women gave birth to 28 healthy infants. One infant was mentally retarded. Another two women died of severe protein malnutrition at the end of their pregnancies.
A total of 19 reoperations were performed in 14 patients, including 5 elongations and 2 restorations. Overall, three patients in the cohort died (4%)—two from protein malnutrition during pregnancy and one from acute pancreatitis.