International Medical Journal, Vol. 23., Iss. 3, 2017, P. 31−34.
BODY WEIGHT REGRESSION IN PATIENTS WITH MORBID OBESITY AFTER HESS - MARCEAU BILIOPANCREATIC DIVERSION
O. O. Shalimov National Institute of Surgery and Transplantology (NAMS of Ukraine), Kyiv, Ukraine
Obesity pandemic has become a powerful stimulus for the rapid development of bariatric surgery. Among the wide spectrum of surgical methods of treating this disease, biliopancreatic bypass surgery modified by the well−known surgeons D. Hess (USA) and P. Marceau (Canada) is one of the most effective surgical interventions. The results of treatment of 100 patients with morbid obesity who were performed biliopancreatic shunt in the modification of Hess −− Marceau as the primary bariatric method in 2011ЃE015 were analyzed to investigate the ways to improve this technique. The main criteria for evaluating the efficacy of the bariatric surgery were the percentage of body weight loss and the percentage loss of body mass index surplus. Their initial values were determined before the surgery and observed in the dynamics for 60 months after the surgery. It was established that implementation of biliopancreatic bypass surgery allowed to achieve good and excellent results of body weight regression in all patients according to the classification of R. Reinhold (1982). The regression of excess body weight and body mass index excess 2 years after the operation was 80.7±20.6 % and 90.3±24.1 %, respectively, with subsequent steady preservation of the result in subsequent years of observation in the range of 77.0±36,6 % and 86.2±41.5 %. Implementation of biliopancreatic shunting in the Hess −− Marceau modification did not lead to body weight deficiency or recurrence of morbid obesity in any of the patients. Thus, the efficacy of this surgical technique was proven.
Key words: morbid obesity, Hess−Marceau biliopancreatic diversion, percent of abundant body mass loss, percent of abundant body mass index loss, body mass regression, abundant body mass regression, body mass deficiency, morbid obesity relapse.