Liver in morbid obesity and effect of bariatric surgery, BPD Scopinaro and DS

Liver in morbid obesity and effect of bariatric surgery, BPD Scopinaro and DS

Joint Event on World Gastroenterological & World Congress on Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada

Simon Biron

Laval University, Canada

Abstract:

Once upon a time, a bariatric general surgeon palpated a liver of normal consistency as he was repairing an incisional hernia, but momentarily recalled the pathology of a biopsy taken at the time of the patient’s bariatric surgery - which had shown liver fibrosis. Very surprised, but staying professional, he didn’t say a word about his finding instead asking for the scalpel to perform a second open biopsy sending the specimen to Pathology as a routine liver biopsy before completing the hernia repair. A week later the surgeon received the Pathology report of normal liver tissue taken at the time of open incisional herniorrhaphy. Surprised, worried, but happy the surgeon checked with the pathologist about differences between the past and present diagnoses of the two liver biopsies. That ‘event’ was a landmark of an unbelievable journey. Years before in February 1984, my esteemed close colleague, Picard Marceau, and I decided to adopt Scopinaro’s Bilio-Pancreatic diversion (BPD) as our major bariatric technique. Needless to say: the disastrous long-term outcomes of jejuno-ileal bypass biased recognition of the value of this new bypass. This prompted us to initiate a prospective systematic follow-up of our patient’s livers and nutritional status. It was, indeed, our duty to perform liver biopsies whenever possible. For quality assurance and ‘blinded’ evaluations we accepted the offer of collaboration with our colleague John G. Kral and the renowned Liver Pathologist Swan N. Thung. Seven cases of bridging fibrosis exhibited normal histopathology upon re-biopsy several years after BPD.

Biography:

Simon Biron has completed his medical degree in 1972 from Laval University and completed his surgical residency training at McGill University in 1977. He has worked at Laval Hospital since 1978 and has served as the Head of the Department of General Surgery from 1993 to 2013. He has been a Clinical Professor of Surgery at the University of Laval since 1981 and served as the Head of Division of General surgery from 2002 to 2012. He has been involved in the writing of approximately 130 articles and 15 books or chapters. He has been an invited speaker to many conferences and has presented numerous posters. He is the principal investigator in N.O.T.E.S. He has been a practicing Bariatric Surgeon since 1981 and currently sits on the Executive of the ASMBS Canadian Chapter.

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