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There is paucity of data on the appropriate bariatric procedure for super obesity (body mass index [BMI] > 50 kg/m2). The aim of this study is to compare the safety and effectiveness of BPD-DS to RYGB and SG in super obese Individual.


The Geisinger bariatric prospectively maintained database was used to perform retrospective analysis on bariatric surgery patients with BMI > 50 between 2015-2019. Two-sample t-tests and Chi-square tests were used to compare BPD-DS to RYGB and SG in terms of Perioperative Outcome, Weight loss, Remission of Diabetes and New onset GERD.


Among 681 patients, 442 (65%) had RYGB, 121 (18%) SG, and 118 (17%) BPD. Age, Gender and preop Diabetes were comparable between groups. BPD group has the lowest percentage of females and had the highest mean BMI. Compared to RYGB and SG, BPD-DS has significantly higher length of stay (2.9 vs 1.6 and 1.5) but comparable 30-day readmission and reoperation. Increase incidence of early complications was higher BPD versus Sleeve (15.4% versus 4.7%). At 3 Year mean follow up BPD-DS had significantly greater total weight loss (41.5% vs 29.9% and 22.2%) and higher diabetes remission rate (96% vs 74% and 57%) compared to RYGB and SG. Conversely Incidence of GERD was higher in BPD Group versus RYGB.


Patients with super obesity have significantly improved weight Loss and Diabetes Remission with BPD-DS but at the cost of higher incidence of adverse events, compared to patients operated with RYGB and SG