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Biliopancreatic Diversion with a Duodenal Switch

Biliopancreatic diversion with a duodenal switch (BPD/DS), also called the "duodenal switch" or the "switch" for short, is a surgical weight loss procedure that generates weight loss by restricting the amount of food that can be eaten, and also limits the amount of food the body will absorb.

General Procedure

The BPD/DS procedure involves the removal of approximately 1/2 to 2/3 of the stomach. This procedure improves on other gastric bypass procedures such as biliopancreatic diversion (BPD) and Roux-en-Y (RNY) by leaving intact more of the stomach and the entire pyloric valve, which regulates the flow of stomach contents into the small intestine.

By dividing the small intestine into two parts, food leaving the stomach avoids the majority of the digestion that takes place in the small intestine.

Compared to other gastric bypass procedures, BPD/DS is one of the most effective at creating long-term weight loss. It is the most successful weight loss surgery at limiting the amount of food the body will absorb. This can put a patient at risk for malnutrition. It's important that a patient is monitored closely by a physician to ensure the proper absorption of vitamins and minerals.

Advantages of biliopancreatic diversion with a duodenal switch (BPD/DS):
  • Ability to eat normal food and drink (as a result of a smaller stomach).
  • Long-term weight loss, particularly for patients with a higher BMI (BMI of 55 or more).
  • Reduced chance of developing an ulcer.
  • The intestinal bypass portion of the surgery is partially reversible for those experiencing significant malnutrition issues.
  • Virtually eliminates dumping syndrome, since the pyloric valve remains intact.
Disadvantages/risks of biliopancreatic diversion with a duodenal switch (BPD/DS):
  • Chance of a hernia where the surgical incision was.
  • Higher chance of chronic diarrhea and foul smelling flatulence.
  • Inability to absorb enough vitamins and minerals to maintain proper nutritional levels.
  • Possible surgical complications due to the complexity of the surgery (more frequent in high risk patients with sleep apnea, heart disease, etc.).
  • Risk of nutritional deficiencies leading to possible anemia, protein deficiency, or metabolic bone disease.

Still have questions? Visit our FAQ page, or sign up for a free informational seminar where our surgeons will talk through each of these processes and answer any questions you might have.