Details of Duodenal Switch

A biliopancreatic diversion with duodenal switch (BPD/DS) is a less-common weight loss procedure that has to major steps: In the first, about 80 percent of the stomach is removed, leaving a banana shaped stomach.

In the second, the majority of intestine is bypassed by connecting the end portion of the intestine to the duodenum near the stomach. Both these steps limit how much the patient can eat.

It is done because of:

• Heart disease
• High blood pressure
• High cholesterol
• Severe sleep apnea
• Type 2 diabetes
• Stroke
• Infertility

This procedure involves: The first step of a BPD/DS. The first step in a BPD/DS involves removing a portion of the stomach. After making the incisions with the open or laparoscopic technique.

The surgeon leaves intact the valve that releases food to the small intestine (the pyloric valve), along with a limited portion of the small intestine that normally connects to the stomach (duodenum).

The second step of a BPD/DS. During the second step, the surgeon makes one cut through the part of the small intestine just below the duodenum, and a second cut farther down, near the lower end of the small intestine. He brings the cut end near the bottom of the small intestine up to the other cut end, just below the duodenum. The effect is to bypass a large segment of the small intestine.

Short term risks are:

• Excessive bleeding
• Infection
• Adverse reactions to anesthesia
• Blood clots
• Lung or breathing problems

Leaks in the gastrointestinal system Long term risks are:

• Bowel obstruction
• Dumping syndrome, resulting in diarrhea, nausea or vomiting
• Gallstones
• Hernias
• Hypoglycemia (low blood sugar)
• Malnutrition
• Stomach perforation
• Ulcers
• Vomiting