A biliopancreatic diversion with duodenal switch (BPD/DS) is a less-common w entails two major steps.
The first step is sleeve gastrectomy in which about 80 percent of the stomach is removed, leaving a smaller tube-shaped stomach. However, the valve that releases food to the small intestine (the pyloric valve) remains, along with a limited portion of the small intestine that normally connects to the stomach (duodenum).
The second step bypasses the majority of the intestine by connecting the end portion of the intestine to the duodenum near the stomach. A BPD/DS both limits how much you can eat and reduces the absorption of nutrients, including proteins and fats.
Why it’s done
A Weight loss surgery is suitable for people who are severely overweight and who have not been able to lose weight with diet, exercise, or medicine.
Most surgeons will not perform duodenal switch surgery unless you are super obese (body mass index (BMI)of 50 or higher) and your weight is causing serious health problems.
It is important to think of this surgery as a tool to help you lose weight. It is not an instant fix. You will still need to eat a healthy diet and get regular exercise. This will help you reach your weight goal and avoid regaining the weight you lose.
How Well It Works
Biliopancreatic diversion surgeries are effective. Most people lose 75% to 80% of their excess weight (the weight above what is considered healthy) and stay at their new weight. Ten years after weight loss surgery, many people have gained back 20% to 25% of the weight they lost. The long-term success is highest in people who are realistic about how much weight will be lost, keep appointments with the medical team, follow the recommended eating plan, and are physically active.
Risks
As with any major surgery, a BPD/DS poses potential health risks, both in the short term and long term.
Risks associated with BPD/DS are similar to any abdominal surgery and can include:
- Excessive bleeding
- Blood clots
- Lung or breathing problems
- Leaks in your gastrointestinal system
Longer term risks and complications of a BPD/DS may include:
- Bowel obstruction
- Dumping syndrome, causing diarrhea, nausea or vomiting
- Gallstones
- Low blood sugar (hypoglycemia)
- Malnutrition
- A higher risc of osteoporosis
- Ulcers
Rarely, complications of a BPD/DS can be fatal.
After the procedure
Eating after surgery
Your doctor will give you specific instructions about what to eat after the surgery. For about the first month after surgery, your stomach can only handle small amounts of soft foods and liquids while you are healing. It is important to try to sip water throughout the day to avoid becoming dehydrated. You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements.
Bit by bit, you will be able to add solid foods back into your diet. You must be careful to chew food well and to stop eating when you feel full. This can take some getting used to, because you will feel full after eating much less food than you are used to eating. If you do not chew your food well or do not stop eating soon enough, you may feel discomfort or nausea and may sometimes vomit. Drinking a lot of high calorie liquid such as soda or fruit juice, you may not lose weight. If you continually overeat, your stomach may stretch. If your stomach stretches, you will not benefit from your surgery.
This surgery removes the part of the intestine where many minerals and vitamins are most easily absorbed. Because of this, you may have a deficiency in iron, calcium, magnesium, or vitamins. Your doctor will recommend that you take vitamin and mineral supplements after surgery, including a multivitamin, calcium and vitamin B12. These are vital to prevent micronutrient deficiency.
You’ll also have frequent medical checkups to monitor your health in the first several months after weight-loss surgery. You may need laboratory testing, bloodwork and various exams.
You may experience changes as your body reacts to the rapid weight loss in the first three to six months after a BPD/DS, including:
- Body aches
- Feeling tired, as if you have the flu
- Feeling cold
- Dry skin
- Hair thinning and hair loss
Biliopancreatic diversion – Results
After a BPD/DS, it may be possible to lose 75 to 80 percent of your excess weight within two years. However, the amount of weight you lose also depends on your change in lifestyle habits.
In addition to weight loss, a BPD/DS may improve or resolve conditions often related to being overweight, including:
- Gastroesophageal reflux disease
- Heart disease
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Type 2 diabetes
- Stroke
- Infertility
A BPD/DS can also improve your ability to perform routine daily activities, which could help improve your quality of life.
