Biliopancreatic diversion (BPD) is a type of gastric bypass, but is more radical than a typical Roux-en-Y. The stomach is reduced in size and connected to the last part of the small intestine. This bypasses two entire sections of intestine, the duodenum and the jejunum.
There are several variations of BPD. One less extreme variation keeps the stomach's pyloric valve intact. Called duodenal switch, this type of bypass surgery regulates the release of stomach contents into the small intestine. The duodenal switch takes longer than a gastric bypass, and is technically more difficult.The complication rate is similar to gastric bypass -- when the procedure is performed by an experienced surgeon. After this option, people can enjoy a wider variety of foods and can eat about half as much as they did before the operation without fear of experiencing dumping syndrome. In addition, calcium loss does not occur following duodenal switch surgery. Although this procedure still requires making some behavioral changes, it may offer better quality of life and social functioning.
BPD is often very successful at causing weight loss. However, stomach ulcers and diarrhea are common complications. Also, as with other forms of weight loss surgery, more serious complications are possible. Malnutrition is the most common of the serious complications. Given that BPD is a more extreme form of weight loss surgery, life-long follow-up programs are recommended.
Marceau P, Biron S, Lebel S, et al. Does bone change after biliopancreatic diversion? J Gastrointest Surg. 2002 September;6(5):690–698.
Anthone GJ. The duodenal switch operation for morbid obesity. Surgical Clinics of North America. 2005 August;85(4):819-833.
Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network.
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