Biliopancreatic Diversion with Duodenal Switch

A biliopancreatic diversion, a weight loss surgery in order to achieve the desired result of loss in weight, is a normal process of digestion which is replaced with the normal stomach with the smaller one. Upon the surgical formalities, the patient’s food bypasses the part of the small intestine so that the patient can absorb the smaller amount of calories. This surgery is the commensurate surgical procedure for obese people, especially for those who have BMI (Body Mass Index) 50 or above.

As a result of this surgery, the patients will feel the fullness more quickly than the previous original stomach’s intake. It results in a healthy amount of reduction in the eating capacity of the patient. Bypassing a portion of the small intestines brings the result of the less amount of the calorie absorption.  This activity, through this biliopancreatic diversion, reaps the ripe harvest of weight loss.

A biliopancreatic diversion surgery has been grouped into two types-a biliopancreatic diversions and a biliopancreatic diversion with duodenal switch. Most of the surgeons will not execute the surgical procedure of biliopancreatic diversion with duodenal switch only with the cases of extreme obesity. 

• In the cases of biliopancreatic diversion, a portion of the stomach is eliminated. The remaining portion of the stomach is rerouted with the lower portion of the small intestines.  The patient who went through this surgical diversion must be taking the vitamins and minerals supplements throughout their rest of lives
• Whereas, in the cases of biliopancreatic diversion with duodenal switch, a different portion of the stomach is eliminated, leaving the pylorus intact. This pylorus acts as the valve to control the food drainage from the stomach.  The DS seems to be more effective in attaining sterling weight loss results in cases of extreme obesity. In the DS procedure, a sleeve resection is performed by eliminating about two-third of the stomach, which maintains the continuation of the gastric lesser curve. The stomach would be left attached with the first segment of the small intestines (duodenum), which allows pylorus- the valve that acts as the controller of food drainage from the stomach-left intact.  Post that, the second portion of the small intestines separated from the rest of the small intestines
• Furthermore, the small intestines reconnect with the lowest part of the small intestines, bypassing the major region of the second and third portion of the small intestines. The small intestines are so well arranged that the juncture where the food mixes with the juices is fairly short. No small intestines are left defunct

These surgical procedures are accomplished upon creating a large incision in the belly as an open procedure or by making a small scar in the belly, and surgical procedure is carried out by using the laparoscopic tools. 

Anticipated Expectation Post-surgery

The patient can feel the postoperative pain, which can be relieved by consuming certain medications for a week or more than a week after the surgery.   After getting the smaller stomach post-surgery, the patient will feel the fullness very quickly when he eats. The smaller stomach will empty the eaten food very too quickly into the small intestines. This activity of emptying is also known as the dumping syndrome. Having the duodenal switch through biliopancreatic diversion lessens the risk of the dumping syndrome. On rare occasions, patients suffer from certain diarrhea, faintness, shakiness, and nausea. It would also be hard at times for the patient’s body to absorb nutrition.

Edible Items Post-Surgery

 Your surgeon will chart out the dietary plan with the instructions to be followed. Within the first month post-surgery, your stomach can be capable enough to digest the small quantity of soft food and liquids during the healing spell. This process will take a certain time to make your new stomach habituated. And, you will get the feeling of fullness too early. If you don’t chew your food properly or you eat too fast, you may feel discomfort or nausea, or maybe sometimes you may vomit. If you drink the beverages laced with high calories, such as soda, fruit juices, you may be left with no weight loss. If you overeat constantly, your new stomach may jeopardize of stretching. If the stretching of your new stomach materializes, you may end up not benefitting from this surgery.   

This surgical procedure brings the removal of a portion of the intestines wherein many minerals and vitamins are absorbed. As a result of this, your body has a deficiency in iron, calcium, magnesium, or vitamins. It is extremely important,ensuring that the patient’s body would be having enough nutrients to prevent the problems of the vitamins and minerals. The patients need to chalk out a well-thought-out dietary plan, apart from consuming extra vitamins B 12.

Why is this surgery executed? 

Weight loss surgery is the effective medium of achieving this goal for those people who are severely overweight and who are unable to get the result of weight loss after dieting, exercising, or prescribed medications. 

Most of the expert surgeons will not perform the duodenal switch surgery unless the patient falls under the category of super-obese where his BMI is 50 or above, causing some serious health problems.

It is essential to ponder over this surgical procedure as a tool to put off certain weight, not as a quick-fix solution to deal with super obesity. The patients still need to follow the health-rending diet and do regular exercise. These activities will yield the result of losing certain weight without regaining the weight.

Advantages of this surgery:

• One of the rudimentary advantages of this surgery is of its quicker result in a very high percentage of weight loss for super obese persons with a very low risk of  putting on weight again
• Various studies show that this surgery resolves around 90 percent of diabetes type-2, 95% of hyperlipidemia, 90 percent of sleep apnea, and 80 percent of hypertension, respectively. The outcome of this surgery is so impressive that some surgeons are performing the switch or intestinal surgery on the non-obese patients for the excellent benefit of remedying the diabetes
• Because of the protection of pyloric valve between the stomach and the small intestines, people who have undergone the duodenal switch don’t encounter with the problems of dumping syndrome, that is very common in the Roux-en-Y Gastric bypass patients
• Adhering to the prescribed dietary plan in the duodenal switch cases are more normal and better tolerated than other surgeries, apart from reversibility capacity of the malabsorptive components
• Problems related to the liver are not found and the stomach ulcer is eliminated through this surgery

Risks and Complications

• Because of the malabsorptive elements of the duodenal switch requires the patient to consume vitamins and minerals supplements throughout the rest of the lives
• Like the Gastric bypass patients, DS patients need to take the lifelong and extensive blood tests for the pursuit of checking the deficiencies in vitamins and certain minerals. Follow-up care is not optional and must be in the continuance as the long as the patient lives his life
• It is quite common for the occurrence of smelly flatus and diarrhea in the DS patients. Although twin of these problems can be alleviated through strict diet plans, including simple carbohydrates and fatty foods.