GASTRIC MUCOSAL CHANGES IN DUODENAL SWITCH OPERATION IN MANAGEMENT OF MORBID OBESITY:PRE- AND POST-OPERATIVE COMPARISON

Objectives: Duodenal switch has proved to be the most effective procedure in management of morbid obesity as it has long-term weight loss outcome and co-morbidity improvement.It is important to study the types of abnormal histopathologic pattern in the gastric mucosa in patients with duodenal switch operation and follow up of those changes 6 month after the operation Methods: 25 morbidly obese patients were included in this study. All patients were treated in the Endocrine Surgery Unit (ESU), Mansoura University Hospitals. ِAll patients did duodenal switch operation ( single anastomosis duodeno-ileal bypass with sleeve gastrectomy) and a biopsy from their gastric mucosa was taken at the time of the operation.Follow up of those patient was done six month after surgery regarding body weight, body mass index, weight loss and a biopsy was taken by upper gastro-intestinal endoscope and compared with the previous data Result:The mean body weight six month after the operation was 116.2 ?15.2 kilo grams in comparison with 156.8 ?14.9 kilo grams at time of surgery with mean weight loss about 40.6 kilo grams and the mean body mass index six month after the operation is 40.7 ?4.4 in comparison with 55.0 ?4.7 at time of surgery with mean body mass index loss about 14. Normal gastric mucosa increased to 12 cases (48%) six month post-operative in comparison to seven cases (28%) at time of operation and Pathologic gastric mucosa decreased to 13 cases (52%) six month post-operative in comparison to 18 cases (72%) at time of operation Conclusion: Open duodenal switch operation (Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy) for morbidly obese patients gives very good results in weight loss and control of diabetes mellitus type II and hypertension. As regards the epithelial changes after surgery it was noticed that there were improvement of the gastric mucosal pathology.