Biliopancreatic Diversion with Duodenal Switch
For individuals struggling with severe obesity, bariatric (or metabolic) surgery can offer significant health benefits, including improvements in conditions like Type 2 diabetes, hypertension and cardiovascular disease.
In the U.S., the most frequently performed procedures include gastric sleeve, gastric bypass, and adjustable gastric banding. Another less common option is the biliopancreatic diversion with duodenal switch, a two-part surgery designed to support long-term weight loss. Discover how this approach works and why it may suit those with complex obesity-related health challenges.
Biliopancreatic diversion with a duodenal switch—abbreviated as BPD/DS—is a procedure that has 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 duodenum is divided just beyond the stomach, and the last portion (distal) of the small intestine is connected to the new stomach pouch. When the patient eats, the food passes through the newly created tubular stomach pouch and empties directly into the last segment of the small intestine. The food stream bypasses roughly three-fourths of the small intestine.
The bypassed intestine, which carries bile and enzymes for digesting fat and protein, is reconnected later to mix with food. Like other surgeries, BPD/DS limits food intake at first, but patients may eventually eat near-normal amounts. Unlike other procedures, it bypasses a large portion of the small intestine.
Food doesn’t mix with digestive enzymes until late in the intestine, reducing absorption of calories, protein fat, and fat-soluble vitamins. Like other surgeries, BPD/DS also affects hormones that control hunger, fullness and blood sugar. It’s considered the most effective weight loss surgery option for treating diabetes.
While BPD/DS is very effective, it also has more risks compared to other bariatric surgeries, including:
- Slightly higher complication rates than other procedures
- Highest malabsorption and a 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 is recommended for individuals with a body mass index (BMI) equal to or greater than 35, regardless of presence, absence, or severity of co-morbidities. Laparoscopic adjustable gastric banding with the Lap Band® is also FDA-approved for weight loss surgery in people with a BMI of 30 to 35 who have at least one obesity-related condition. Weight loss surgery is considered safe, but like many types of surgery, it does have risks. Consult with your physician about the risks and benefits of weight loss surgery. These testimonials reflect results achieved by these patients. As each case must be independently evaluated and managed, actual weight loss will vary.
Our Free Bariatric Webinar
When you’re ready to learn more about making a change for the better, register for our free bariatric informational webinar.
Are you a candidate?
Find out if weight loss surgery is right for you.