Biliopancreatic Diversion with Duodenal Switch (BPD/DS): A Malabsorptive Procedure. Malabsorptive procedures reduce the size of the stomach. However, the pouch is a bit larger than with other procedures. The pouch is connected to the lower part of the small intestine. Connecting to the lower part of the small intestine means that absorption of calories and nutrients is reduced greatly. There are three malabsorptive procedures: Biliopancreatic Diversion with Duodenal Switch, Biliopancreatic Diversion, and Extended Roux-en-Y gastric bypass surgery.
Biliopancreatic Diversion with Duodenal Switch In this version of BPD, stomach removal is limited to the outer margin, creating a sleeve of stomach. The duodenum, the first portion of the small intestine, is divided so that pancreatic and bile drainage are bypassed.
Advantages of Biliopancreatic Diversion with Duodenal Switch
A 2004 meta-analysis of more than 22,000 patients showed that those who underwent a bariatric surgical procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.
- BPD had the highest rate of type 2 diabetes resolution of all the different bariatric surgery procedures: 98.9 percent.
- BPD had the highest rate of hyperlipidemia resolution: 99.1 percent.
- 75.1 percent of hypertension cases were resolved or improved.
- 91.9 percent of sleep apnea cases were resolved.
- Excess weight loss was roughly 70.1 percent.
- These operations often resulted in a high degree of patient satisfaction because patients were able to eat larger meals than with a purely restrictive or standard Roux-en-Y gastric bypass procedure.
- These procedures could produce the greatest weight loss because they have the highest rates of malabsorption.
- Long-term maintenance of excess body weight loss could be successful if the patient adjusts to and maintains an easy-to-follow dietary, supplement, exercise, and behavioral routine.
- As with every type of bariatric surgery, the overall quality of life for patients improved greatly. A great deal of excess weight was lost, and patients experienced resolution of co-morbidities, and improved appearance, social opportunities, and economic opportunities.
Risks and Disadvantages of Biliopancreatic Diversion with Duodenal Switch
- There is a period when the intestines adjust and bowel movements can be very liquid and frequent. This condition may lessen over time, but may be a lifelong condition.
- Abdominal bloating and foul-smelling stool or gas may occur.
- Patients and their primary care physicians should monitor for protein malnutrition, anemia, and bone disease throughout the patient’s life. Patients also need to take vitamin supplements for the rest of their lives. Not taking either of these precautions can lead to health issues that require treatment. In fact, it’s been found that if patients do not follow eating and vitamin supplement instructions closely, at least 25 percent will develop problems that require treatment.
- Changes to the intestinal structure can increase the risk of forming gallstones and the need for removal of the gallbladder.
- Patients should be aware of the possibilities of intestinal irritation and ulcers.
- The procedure could result in death.