Duodenal Switch

The biliopancreatic diversion with duodenal switch (BPD/DS), or more commonly referred to as the Duodenal Switch, is a traditional but very aggressive form of weight loss surgery. The duodenal switch has been performed since the 1980’s but currently comprises only about 1% of all bariatric procedures as the powerful weight loss is accompanied by a slightly higher risk profile. However, with a highly experienced surgeon, it can be an excellent option for patients whose individual needs align with its benefits.

Here’s How it Works:

First, a sleeve gastrectomy is performed where a significant portion of the stomach is removed. The remaining stomach is shaped like a large banana and resembles a tube or sleeve.

Then, the first part of the small intestine (duodenum) is divided just after the stomach. The mid-small intestine is then divided, and one end reattached to the duodenum. The other end is reattached to the downstream small intestine leaving only a short length of intestine to combine food with digestive secretions.

When the patient eats, food goes through the newly narrowed stomach and directly into the latter portion of the small intestine so that it bypasses a majority of the small bowel, resulting in significantly decreased absorption of fat and calories.

The Benefits of Duodenal Switch:

1. Provides the most weight loss of any major weight loss surgery.
2. The most effective procedure available for treating type 2 diabetes.
3. Powerful appetite suppression.

Disadvantages:

1. Slightly higher complication rate than other bariatric procedures.
2. More malabsorption and higher risk of nutritional deficiencies.
3. Risk of more frequent bowel movements or diarrhea.
4. May not be good option for patients with severe acid reflux.
5. More complex procedure with longer operating times.