Biliopancreatic Diversion with Duodenal Switch

Biliopancreatic Diversion with Duodenal Switch

Click to Schedule

Click to

Schedule Online

Call

(816) 525-2840

Text

(816) 551-2339

Walk-In

Locations

Biliopancreatic Diversion with Duodenal Switch

The Biliopancreatic Diversion with Duodenal Switch—abbreviated as BPD/DS—is a procedure with two components. First, a portion of the stomach is removed to create a smaller, tubular stomach pouch, similar to the sleeve gastrectomy. Next, a large portion of the small intestine is bypassed.

The Procedure

The duodenum, or the first portion of the small intestine, is divided just past the stomach outlet. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach so that when the patient eats, the food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream.

The bypassed small intestine, which carries the bile and pancreatic enzymes necessary for the breakdown and absorption of protein and fat, is reconnected to the last portion of the small intestine to mix with the food stream eventually. Like the other surgeries described above, the BPD/DS initially helps reduce the amount of food consumed; however, over time, this effect lessens, and patients can eventually consume near “normal” amounts of food. Unlike the other procedures, there is a significant amount of small bowel that is bypassed by the food stream.

The food also mixes with the bile and pancreatic enzymes very far down the small intestine. This results in a significant decrease in the absorption of calories and nutrients (particularly protein and fat) and nutrients and vitamins dependent on fat for absorption (fat-soluble vitamins and nutrients). Lastly, the BPD/DS, similar to the gastric bypass and sleeve gastrectomy, affects gut hormones in a manner that impacts hunger and satiety as well as blood sugar control. The BPD/DS is considered to be the most effective surgery for the treatment of diabetes among those that are described here.

DR JOSEPH BARIATRICS
Advantages
  • Results in more significant weight loss than RYGB, LSG, or AGB, i.e. 60 – 70% percent excess weight loss or greater, at five year follow up
  • Allows patients to eat near “normal” meals eventually
  • Reduces the absorption of fat by 70 percent or more
  • Causes favorable changes in gut hormones to reduce appetite and improve satiety
  • Is the most effective against diabetes compared to RYGB, LSG, and AGB
Disadvantages
  • It has higher complication rates and risk for mortality than the AGB, LSG, and RYGB
  • Requires a more extended hospital stay than the AGB or LSG
  • It has a greater potential to cause protein deficiencies and long-term deficiencies in a number of vitamins and minerals, i.e. iron, calcium, zinc, fat-soluble vitamins such as vitamin D
  • Compliance with follow-up visits and care and strict adherence to dietary and vitamin supplementation guidelines are critical to avoiding serious complications from protein and certain vitamin deficiencies
Man and woman stretching in open field

The risks of duodenal switch bariatric surgery include higher complication rates and mortality risk, a longer hospital stay, and the potential for protein deficiencies and long-term deficiencies in several vitamins and minerals.

The recovery period after duodenal switch surgery can vary depending on the individual but typically takes several weeks to a few months. It is usual for patients to be kept in the hospital for a few days for observation and to manage any pain or complications. They may be given pain medication and antibiotics to prevent infection.

Duration of the duodenal switch procedure can vary depending on several factors, such as the patient’s anatomy, the surgeon’s experience, and the complexity of the procedure.

Typically, the operation takes two to four hours to complete. However, the duration of the surgery does not necessarily determine the success of the procedure, and the surgeon will prioritize ensuring the safety and well-being of the patient over completing the procedure quickly.

Find a Surgeon

dr radzevich bariatrics
Dr. Joe Radzevich

Bariatrics, Acute Care Surgery

DR JOSEPH
Dr. Sigi Joseph

Bariatrics, Acute Care Surgery

Reviews