@article{ref1,
title="Long-Term Experience with Duodenal Switch in Adolescents",
journal="Obesity surgery",
year="2010",
author="Marceau, Picard and Marceau, Simon and Biron, Simon and Hould, Frederic-Simon and Lebel, Stefane and Lescelleur, Odette and Biertho, Laurent and Kral, John G.",
volume="20",
number="12",
pages="1609-1616",
abstract="Background Severe or extreme obesity in children and adolescents is a progressive damaging disease, increasingly requiring surgical treatment. Timing and choice of operation are controversial. <br><br>METHOD In the last 16 years, we performed open biliopancreatic diversion with duodenal switch (DS) in 13 adolescents aged 15-17 years, who have been followed up for 2-16 years (mean, 10.6 years); three with Prader-Willi syndrome (PWS) are presented separately. <br><br>RESULTS Among the ten non-PWS children (7 girls), no deaths or perioperative complications were reported, mean body mass index (BMI) decreased from 55.9 ± 14.0 to 28.8 ± 3.7 kg/m2 (% excess weight loss (EWL) = 82.1 ± 10.5%), and none have regained weight. All comorbidities were cured except asthma, which improved in one patient. There were two reoperations: one for intestinal obstruction and one for post-anastomotic ulcer. Glucose and lipid metabolism improved, while vitamin and mineral deficiencies were mild and rare. Five of the seven girls gave birth to 11 children, aged 2-12 years, two of whom are overweight but not severely obese. Neurodevelopment is age-appropriate in all 11 individuals. PWS children, aged 15-16 years, had postoperative respiratory and infectious complications necessitating hospitalizations of 13-22 days (versus 5.1 ± 1.2 days in non-PWS). Weight loss and comorbidity improvement lasted approximately 5 years, providing improved quality of life for patient and family. One PWS patient died from complications after reoperation for weight regain after 4 years. One was reoperated after 6 years and the third is considering reoperation 14 years after primary DS. <br><br>CONCLUSION The beneficial effects of DS in adolescents exceed the risks, even in the presence of PWS.<p /><p>Language: en</p>",
language="en",
issn="0960-8923",
doi="10.1007/s11695-010-0262-4",
url="http://dx.doi.org/10.1007/s11695-010-0262-4"
}