TECHNICAL FEATURES OF THE IMPLEMENTATION OF SLEEVE GASTRECTOMY AND BILIOPANCREATIC DIVERSION IN THE TREATMENT OF OBESE PATIENTS

Background. Steady growth of the number of people with excessive weight is observed almost in all economically developed countries. According to the World Health Organization (WHO), about 30% of people had excessive weight by the end of the twentieth century. Thereby, assimilation and improvement of the methods of bariatric surgeries is an actual task.

Aim of the study. To estimate technical features and the results of sleeve gastrectomy and biliopanсreatic diversion (Hess-Marceau modification).

Methods. During the period from 2009 to 2012 year bariatric surgery was performed in 24 patients (16 women and 8 men). Patients’ age ranged from 28 to 59, BMI range from 31.6 to 80 kg/m2. Biliopanсreatic diversion (Hess-Marceau modification) was performed on 18 patients (with BMI > 40 kg/m2). Sleeve gastrectomy was performed in 6 patients (with BMI range from 31.6 to 47.7 kg/m2).

The main complaints of patients with morbid obesity were a progressive increase in body weight, with no effect from other methods of treatment (diet, drug therapy, intragastric balloon), severe shortness of breath with little exertion, pain in the back and in large joints of lower limbs, different degrees of manifestation of Pickwickian syndrome (night snoring, apnoea, daytime sleepiness). Body mass, carbohydrates and fats metabolism rates were controlled.

Results. All patients reported a significant reduction in appetite after surgery. It was reported a median percentage of excessive weight loss (%EWL) by 49% within the first year after the operation, 64% EWL after two years.

Conclusions. Biliopanсreatic diversion (Hess-Marceau modification) leads to a significant reduction in body weight and normalization of lipid and carbohydrate metabolism and in two years a median %EWL is 72%. Sleeve gastrectomy reduces %EWL by 64% within 2 years after surgery.