OBJECTIVE

To develop patient selection criteria and requirements for surgery, to evaluate the results of plastic surgeries in patients after massive weight loss following pylorus-preserving modifications of biliopancreatic diversion (BPD).

MATERIAL AND METHODS

The study included 65 patients who underwent BPD surgery in SADI (n=34) and Hess-Marceau (BPD-DS; n=31) modifications and subsequent post-bariatric plastic surgeries (PBPS). Patient satisfaction with postoperative aesthetic and functional results was assessed using the Likert scale.

RESULTS

PBPS in the SADI group was performed in 27.4±13.6 months after BPD, in the BPD-DS group — after 27.9±14.9 months. Combined plastic surgeries with gastrointestinal tract reconstruction were carried out in 10 (29.4%) and 6 (19.4%) patients, respectively. Combined surgeries were performed in 28 (82.4%) and 23 (74.2%) patients in SADI and BPD-DS groups, respectively. Complication rate was 26.5% and 45.2%, respectively. Most of events didn’t require hospital-stay and regressed within 1—2 months under conservative treatment. For most patients, maximum scores in assessing the contour, location of postoperative scars, and aesthetics of umbilicus were obtained.

CONCLUSION

PBPS is an integral part of treatment in patients with morbid obesity. These procedures are often performed as a part of combined surgery. They can be successfully used in combination with reconstructive bariatric surgeries without increase of postoperative complication rate. Patient satisfaction with PBPS outcomes reaches 100%.