Case Report

Metabolic and cardiovascular improvements after biliopancreatic diversion in a severely obese patient

Philippe Woods , Carmen Paquette , Julie Martin , Jean-Gaston Dumesnil , Picard Marceau , Simon Marceau , Simon Biron , Frédéric Hould , Odette Lescelleur , Stéphane Lebel and Paul Poirier

Institut universitaire de cardiologie et de pneumologie, Hôpital Laval, 2725 Chemin Ste-Foy, Quebec, Qc, Canada, G1V 4G5

author email corresponding author email

Cardiovascular Diabetology 2004, 3:5doi:10.1186/1475-2840-3-5

Published:	27 April 2004

Abstract

Background

Severe obesity is associated with important morbidity and increased mortality. The successes of lifestyle modifications and drug therapy have been partial and mostly unsustained in reducing obesity and its comorbidities. Bariatric surgery, particularly biliopancreatic diversion with duodenal switch reduces efficiently excess body weight and improves metabolic and cardiovascular functions.

Case presentation

A 56-year-old man with severe clinical obesity underwent a biliopancreatic diversion with a duodenal switch after unsuccessful treatment with weight loss pharmacotherapy. He had diabetes, hypertension and sleep apnea syndrome and was on three medications for hypertension and two hypoglycemic agents in addition to > 200 insulin units daily. Eleven months after the surgery, he had lost 40% of his body weight. The lipid profile showed great improvement and the hypertension and diabetes were more easily controlled with no more insulin needed. The pseudonormalized pattern of left ventricular diastolic function improved and ventricular walls showed decreased thickness.

Conclusion

Biliopancreatic diversion may bring metabolic and cardiovascular benefits in severely obese patients from a cardiovascular perspective.