BPD/DS stands for Biliopancreatic Diversion with Duodenal Switch.
There are 2 parts to the procedure. The first is removing a large part of your stomach, the second is bypassing part of your small intestine.
How the surgery is done
First, your surgeon creates a smaller, tubular stomach pouch by removing part of your stomach.
Then they detach your duodenum, (the first portion of your small intestine) just past the outlet of your stomach. A segment of the last portion of your small intestine is then brought up and connected to the outlet of the newly created stomach.
The idea is that when you eat, your food goes through the new stomach pouch and empties directly into the last segment of your small intestine. Roughly ¾ of your small intestine is bypassed.
The bypassed small intestine carries bile and pancreatic enzymes which you need to break down and absorb protein and fat. So your surgeon reconnects it to the last portion of your small intestine so the bile and enzymes can eventually mix with the food stream.
The surgery takes 2½ to 4 hours. Average time off work is 2 to 4 weeks.
How it works
The BPD/DS gastric bypass initially helps you to reduce the amount of food you eat. Over time this effect lessens and you’ll eventually be able to consume near-normal amounts of food.
Since the food doesn’t mix with bile and pancreatic enzymes until it gets quite a long way down your small intestine, the absorption of calories and nutrients (particularly protein and fat) is significantly reduced.
Lastly, it affects gut hormones in a way that reduces hunger, increases feeling full and reduces blood sugar.
- it results in 60% – 70% excess weight loss or more (at 5 year follow-up)
- you can eventually eat near-normal meals
- it reduces fat absorption by 70% or more
- it changes your gut hormones, reducing your appetite.
- the surgery isn’t reversible
- complications occur in 6% of surgeries
- complications can include food intolerance, duodenal leak, gastric leak, abscess, obstruction, blood clot, bleeding, heart attack, pneumonia, collapsed lung, stenosis, infection, and pancreatitis
- you'll be in hospital longer than with an adjustable gastric band or sleeve (3 – 7 days)
- it can cause protein deficiencies (18%) as well as long-term vitamin and mineral deficiencies
- you'll need regular follow-up visits
- you’ll need to take vitamin and mineral supplements for the rest of your life to avoid serious complications.