Biliopancreatic Diversion with Duodenal Switch in Louisiana

The Biliopancreatic Diversion with Duodenal Switch (BPD/DS) is an operation that is approved by the American Society of Metabolic Bariatric Surgery (ASMBS) for morbidly obese patients, but it is not widely done in the United States. The Surgical Specialists of Louisiana are one of the few programs nationally who perform laparoscopic biliopancreatic diversion with duodenal switch.

As opposed to adjustable gastric banding or sleeve gastrectomy, patients lose weight after this operation primarily because of malabsorption of calories, rather than restriction of caloric intake. A large segment of the intestines is bypassed during this operation so that only a fraction of the food ingested comes in contact with digestive enzymes and thus only a portion of the calories are used by the body. The size of the stomach is reduced, but most people can eat a normal meal after recovery from surgery.

Duodenal Switch Surgery Results

Multiple studies show that this is an excellent operation for achieving and maintaining long-term weight loss (~90% excess weight loss at 5 years) with low complications. The complication rate is slightly higher than with other weight loss operations, and the hospital stay is longer (3-5 days). Because of the malabsorptive component, it is essential that patients maintain their protein and vitamin intake and are attentive to the scheduled follow up program.

There are also health and quality of life benefits to having this surgery. Studies found that BPS/DS:

• Resolved type 2 diabetes in 98.9% of patients*
• Resolved high blood pressure in 75.1% of patients*
• Improved high cholesterol in 99.1% of patients*
• Resolved obstructive sleep apnea in 91.9% of patient*
• Improved the overall quality of life, physical functioning, and social and economic opportunities

*Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery: A Systematic Review and Meta-Analysis. JAMA 2004;292(14):1724-37.

Potential Duodenal Switch Patient Concerns

• Abdominal bloating and foul-smelling stool or gas may occur.
• Because of the malabsorptive component, it is essential that patients maintain their protein intake and adhere to their follow up program.
• Patients also need to supplement with daily multivitamins and calcium and may be prescribed vitamin B12 and iron by their healthcare professional.