Bilio-pancreatic Diversion:

The DS is more effective in achieving excellent weight loss in the extremely obese. In the DS, a sleeve resection of the stomach is performed by removing about 2/3 of the stomach, maintaining continuity of the gastric lesser curve. The stomach remains attached the first segment of the small intestine, the duodenum, which allows pylorus, the valve that controls food drainage from the stomach, to be left intact. The 2nd part of duodenum is then separated from the rest of the small intestine. The duodenum is then attached to the lowest part of the small intestine, bypassing the majority of the second and third segments of the small intestine. The small intestines are arranged so that the section where the food mixes with the digestive juices is fairly short. No small intestine is defunctionalized.

Bilio Pancreatic
Who needs BPD-DS?

Same as Gastric bypassPeople who want to eat normally
Advantages

The primary advantage of duodenal switch (DS) surgery is that it results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain.Various clinical studies showed resolution of type 2 diabetes [90%], hyperlipidemia [95%], sleep apnea [90%], and hypertension [80%]. The results are so favorable that some surgeons are performing the “switch” or intestinal surgery on non-obese patients for the benefits of curing the diabetes.Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the DS do not experience the dumping syndrome common with people who’ve undergone the Roux-en-Y gastric bypass surgery.Diet following the DS is more normal and better tolerated than with other surgeries. The malabsorptive component is fully reversible.Liver problems are much less frequent and the procedure essentially eliminates stomal ulcer.
Risks and Complications:

The malabsorptive element of the DS requires that those who undergo the procedure take vitamin and mineral supplements above and beyond that of patients having the gastric bypass surgery.Like Gastric bypass patients, DS patients require lifelong and extensive blood tests to check for deficiencies in vitamins and minerals. Follow-up care is non-optional and must continue for as long as the patient lives.DS patients also have a higher occurrence of smelly flatus and diarrhea, although both can usually be mitigated through diet, including avoiding simple carbohydrates and fatty foods

Article by
Columbiaasia Hospitals
Bangalore