Biliopancreatic Diversion with Duodenal Switch

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Biliopancreatic diversion with duodenal switch is a two-part bariatric surgical procedure. The first step involves removing part of the stomach leaving only a narrow sleeve. This is followed by a technique that allows a large portion of the small intestine to be bypassed.

Biliopancreatic diversion with duodenal switch procedure

The biliopancreatic diversion with duodenal switch procedure, also called a BPD/DS or simply duodenal switch, is a weight loss surgery that is typically reserved for the severely obese. The first portion of the procedure involves reducing the size of the stomach, leaving behind only a slender tube and limiting the amount of food that can comfortably be consumed.

Next, the small intestine is divided and the lower end of the small intestine is connected directly to the remaining portion of stomach while the majority of the small intestine is bypassed. This allows the stomach to empty directly into the lower section of the intestine, dramatically decreasing the number of calories and nutrients absorbed.

Finally, the portion of the small intestine that was bypassed is reconnected to the lower end of the small intestine. This enables bile and pancreatic enzymes carried by the bypassed intestine to mix with food products for only a brief time significantly reducing calorie and nutrient absorption.

Who is a candidate for the biliopancreatic diversion with duodenal switch procedure?

Since biliopancreatic diversion with duodenal switch is a complicated procedure, it is typically reserved for extremely obese individuals, particularly those with weight-related health issues, who have failed at other weight loss attempts.

Since individuals typically lose more weight with BPD/DS than with other bariatric procedures, it may be recommended to individuals with the following:

  • Body Mass Index of 55 or higher
  • Type 2 diabetes
  • Sleep apnea
  • Hypertension
  • Elevated cholesterol levels

While many individuals with obesity-related health issues experience good results from the duodenal switch procedure, it is important to note the surgery is a complicated one and the individual’s overall health should be taken into account before undergoing the somewhat lengthy procedure.

Pros & Cons of biliopancreatic diversion with duodenal switch

The surgery is considered one of the most successful for weight loss and many individuals are able maintain that loss over the years. Those who undergo BPD/DS are also able to eat relatively normal meals and feel more satisfied.

Disadvantages of the procedure include a higher risk of long term complications including osteoporosis and anemia. Deficiency of fat soluble vitamins (A,D,E, and K) as well as calcium and iron. Some individuals also develop a serious protein deficiency resulting in severe malnutrition.

Before undergoing the procedure, candidates should show a willingness to commit to ongoing follow-up. Individuals who have BPD/DS must be on a lifelong regimen of vitamin and mineral supplements and be medically monitored.