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Comparison of Obesity Surgeries Turns Up Surprising Results
Date:9/18/2012

By Steven Reinberg
HealthDay Reporter

MONDAY, Sept. 17 (HealthDay News) -- Researchers who compared two types of weight-loss surgery found the less popular method -- called the duodenal switch -- results in better maintained weight loss than gastric bypass.

Gastric bypass, considered the gold standard of obesity operations, involves reducing the size of the stomach and bypassing the pyloric valve, which separates the stomach from the small intestine. In a duodenal switch, surgeons leave the pyloric valve intact. This prevents some complications associated with gastric bypass and allows for more normal digestion, which preserves vital nutrients, the researchers said.

"Surgeons are seeing ... a significant number of patients with weight gain after gastric bypass," said Dr. Alec Beekley, associate professor of surgery at Thomas Jefferson University Hospitals in Philadelphia and author of an editorial accompanying the study, which was published in the September issue of the journal Archives of Surgery. Beekley was not involved in the study.

Maintaining weight loss after gastric bypass surgery is a challenge, and over time the weight loss is not nearly as dramatic as after the initial operation, he said.

"Duodenal switch has superior weight loss and may be more appropriate as the primary bariatric operation in carefully selected patients," Beekley said.

Risks early on are higher with the duodenal switch, but the absolute risk of complications is low, the study authors said. Surgeons also have been reluctant to use duodenal switch because the nutritional requirements and need for follow-up are much higher with this procedure, he said.

"Yet, given the clear outcome advantages in terms of weight loss, perhaps it is time more U.S. surgeons considered this option," Beekley said.

For the study, a team led by Dr. Daniel Nelson of Madigan Army Medical Center in Fort Lewis, Wash., compared ou
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