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conferenceseries
.com
Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Bariatric Surgery 2018 & Gastro 2018
March 15-16, 2018
JOINT EVENT
12
th
Global Gastroenterologists Meeting
3
rd
International Conference on Metabolic and Bariatric Surgery
&
March 15-16, 2018 Barcelona, Spain
Long term outcome after Biliopancreatic diversion in Prader-Willi syndrome
Antonino Crino, Danilo Fintini, Alessio Convertino, Sarah Bocchini
and
Graziano Grugni
Bambino Gesu Hospital, Italy
Background:
Improvement in weight control remains the most important goal of any treatment program in Prader-Willi syndrome
(PWS). To date, bariatric surgery experience in Prader-Willi syndrome (PWS) is limited, and different procedures have been used
with varying success. Malabsorptive procedures, such as biliopancreatic diversion (BPD), are not always recommended for PWS due
to lack of safety data and can involve long-term complications.
Patients & Methods:
We report 10 severely obese patients (6 males) with genetically confirmed PWS (7 del15, 3 UPD15) who
underwent Scopinaro’s BPD after inability to control food intake with the classical approaches. Surgery was performed on patients
aged 18.8±3 yrs. (mean±SD) (range: 15.4-24.4) and the BMI (kg/m2) was ≥40 in all cases (49.9±6.7). At baseline, severe co-morbidities
were present, such as obstructive sleep apnea (OSAS), type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome and/or
steatohepatitis.
Results:
No perioperative complications were observed. After a follow-up period of 13.9±7.3 yrs. (range 4.8-27; mean age at follow-
up: 32.5±6.8 yrs) the maximum weight loss % (MWL%) was 30.7±10 (10.1-52.6). Following BPD, BMI decreased in six patients,
stable in three subjects and increased in one individual. The mean BMI at the last visit was 40.5±8.8 (28.9-51.6). After BPD, appetite
was reduced in seven cases; eight subjects had hypochromic anemia and seven had diarrhea; OSAS were present in 5 patients and
osteoporosis/osteopenia in all individuals. T2DM disappeared and behavioral problems improved in some cases. One patient
suddenly died at the age of 37.3 yrs. After surgery all patients received medical therapy to prevent nutritional deficiency.
Conclusion:
The long-term outcome of BPD in our PWS seems to be favorable, with a significant reduction of weight excess in the
majority of subjects. Thus, BPD seems to be a good option in the presence of severe comorbility and in selected PWS patients, with co-
operating families, when other classical approaches have failed. Due to the presence of specific side effects of the procedure, however,
a careful long-term multidisciplinary follow-up is always necessary.
Recent Publications
1.
S Bocchini, D Fintini, G Grugni, A Boiani, A Convertino and A Crinò (2017) Congenital hypothyroidism due to ectopic
sublingual thyroid gland in Prader-Willi syndrome: a case report. Ital J Pediatr. 43(1):87.
2.
Maltese P E, Iarossi G, Ziccardi L, Colombo L, Buzzonetti L, Crinò A, Tezzele S and Bertelli M (2017) A next generation
sequencing custom gene panel as first line diagnostic tool for atypical cases of syndromic obesity: application in a case of
Alström syndrome. Eur J Med Genet. 61(2):79-83.
3.
Rigamonti A E, Crinò A, Bocchini S, Convertino A, Bidlingmaier M, Haenelt M, Tamini S, Cella S G, Grugni G and Sartorio
A (2017) GHRH plus arginine and arginine administration evokes the same ratio of GH isoforms levels in young patients
with Prader-Willi syndrome. Growth Horm IGF Res. pii: S1096-6374(17)30108-9.
4.
Brunetti G, Grugni G, Piacente L, Delvecchio M, Ventura A, Giordano P, Grano M, D’Amato G, Laforgia D, Crinò A and
Faienza M (2018) Analysis of circulating mediators of bone remodelling in Prader-Willi syndrome. Calcif Tissue Int. doi:
10.1007/s00223-017-0376-y.
5.
S Allas, A Caixàs, C Poitou, M Coupaye, D Thuilleaux, F Lorenzini, G Diene, A Crinò, F Illouz, G Grugni, Diane Potvin, S
Bocchini, T Delale, T Abribat and M Tauber (2018) AZP-531, an unacylated ghrelin analog, improves food-related behavior
in patients with Prader-Willi syndrome: A randomized placebo-controlled trial. PLoS One 13(1):e0190849.
Antonino Crino et al., J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C1-064