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Biliopancreatic Diversion with Duodenal Switch

For people with severe obesity, weight loss surgery (also called bariatric and metabolic surgery) can help improve many obesity-related problems, such as Type 2 diabetes, high blood pressure and heart disease. The most common weight loss surgeries in the United States are gastric sleeve, gastric bypass and adjustable gastric band. A biliopancreatic diversion with duodenal switch is a less common weight loss procedure that requires two major steps. Learn more about this procedure and how it works to achieve lasting weight loss for people with severe obesity.

What Is A Biliopancreatic Diversion with Duodenal Switch?

Like sleeve gastrectomy, bilipancreatic diversion with duodenal switch begins with removing most of the stomach, leaving only a banana-shaped section closed with staples. After creating a sleeve-like stomach, surgeons proceed to a second surgical procedure, which involves dividing the small intestine into two tracts. A portion of the small intestine is then brought up and connected to the outlet of the newly created stomach. Food goes through the sleeve pouch and into the latter part of the intestine.

How It Works

The new and smaller banana-shaped stomach allows patients to eat less as the food stream bypasses roughly 75% of the small intestine, which significantly reduces a person’s calorie and nutrient absorption. Additionally, biliopancreatic diversion with duodenal switch allows patients to lose more weight compared with other bariatric surgeries by affecting intestinal hormones in a way that lessens hunger while increasing fullness and improves blood sugar control after eating. It is considered the most effective procedure for treating Type 2 diabetes and improving obesity.

What Are the Disadvantages of Biliopancreatic

While biliopancreatic diversion with duodenal switch is very effective, it also has more risks compared to other bariatric surgeries, including:

  • Slightly higher complication rates than other procedures
  • Highest malabsorption and greater possibility of vitamin and micronutrient deficiencies
  • Possibility of developing or worsening reflux and heartburn
  • Risk of looser and more frequent bowel movements
  • More complex surgery requiring more operative time

The type of bariatric surgery that may be best to help a person safely lose weight depends on various factors. Patients must be willing to make irreversible changes to achieve the desired results after surgery. If you are considering bariatric surgery, talk with your primary doctor to help you decide which approach is best for your weight loss goals.

Weight loss surgery may be an option for adults with a body mass index (BMI) equal to or greater than 40, or equal to or greater than 35 with serious health problems related to obesity. Laparoscopic adjustable gastric banding may be an option for people with a BMI of 30 or more who have at least one serious obesity-related health problem. Weight loss surgery is considered safe, but like any surgery, it does have risks. Consult with your physician about the risks and benefits of weight loss surgery.
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