The Biliary Pancreatic Diversion with Duodenal Switch (Duodenal Switch) is an established weight loss procedure which can provide both excellent long term weight loss and long term resolution of comorbid conditions. This operation can provide patients with a higher degree of satisfaction than a standard Roux-en-Y gastric bypass or purely restrictive operation because they are able to eat larger meals. This operation provides the highest degree of malabsorption and therefore the greatest excess weight loss compared to other operations.
This operation is performed laparoscopically and takes 2-3 hours and involves 2-3 day hospital stay. The operation involves removing 2/3rds of the stomach. The small intestine is divided and rerouted in such a way to create a component of malabsorption. The divided and rerouted small intestine involves a “biliary pancreatic limb” which drains bile and pancreatic juices from the liver and pancreas to the intestine. The “alimentary limb” is connected to the pylorus (distal part of stomach) which serves to route food to the “common channel” where food meets with digestive juices from the “biliary pancreatic limb” to allow digestion. The absorption of food occurs along the length of the common channel.
Risks
This operation requires high patient compliance to dietary regimen, vitamin regimen and follow up for the rest of their life. Common risks include diarrhea, malodorous stool, malnutrition, vitamin deficiencies, leak, stricture, and ulcers.
*Individual results can vary
Banding | Sleeve Gastrectomy | Gastric Bypass | Duodenal Switch | |
Invasiveness | Least | MIddle | Most | Most |
Excess Weight Loss | 40-60% | 50-65% | 50-70% | 80-90% |
Rate of Weight Loss | Slower | Faster | Fastest | Fastest |
Survival Rate | 999/1000 patients | 998/1000 patients | 998/1000 patients | 990/1000 patients |
Complications | Occur Later | Occur Early | Occur Early or Late | Occur Early or Late |
Adjustable | Yes | No | No | No |
Reversible | Yes | No | Very Difficult | Very Difficult |
Implanted Device | Yes | No | No | No |
Hospital Stay | < 1 Day | 1-2 Days | 2 Days | 2-3 Days |
Time Off Work | 1 Week | 1-2 Weeks | 2 Weeks | 2 Weeks |
US Track Record | Since 1991 | Since 2000 | Since 1960s | Since 1950s |
Anti Inflammatory | Ok | Ok | Not Ok | Not Ok |
Follow Up | Most Frequent | Least Frequent | More Frequent | Most Frequent |
Weight Regain | Yes | Yes | Yes | Less Likely |
Convert Procedure to Another | Yes | Yes | No | Yes |