Biliopancreatic Diversion with Duodenal Switch for Massive Weight Loss
Biliopancreatic diversion with duodenal switch (BPD/DS), performed by Long Beach surgeon Joseph Naim, is a combination of bariatric surgery techniques used to create a smaller stomach and limit nutrient and calorie absorption, resulting in massive weight loss. It is intended for patients with a body mass index (BMI) of 50 or greater. Due to its complexity and increased risks, BPD/DS should only be performed by a highly experienced bariatric surgeon. Dr. Naim's private practice, recognized by the American Society for Bariatric Surgery as a Center of Excellence, has a very high rate of patient success. To learn more about BPD/DS, or to schedule a personal consultation with Dr. Naim, please contact us today.
About the Surgery
BPD/DS is considered the best surgery for patients with a BMI greater than 50 who wish to improve obesity-related health problems. The average amount of excess weight lost after the procedure is approximately 70%. It is usually performed laparoscopically (using small incisions, small surgical tools, and an endoscope). In the first stage of the procedure, a large portion of the stomach (approximately 80%) is removed so that it resembles a tube or sleeve (as in sleeve gastrectomy). The second stage involves rerouting the intestine so the body has less time to absorb calories and fat. This is accomplished by connecting the end of the large intestine to the first section of the small intestine, called the duodenum.
Following surgery, you will stay in the hospital for two to three days so that Dr. Naim can be certain that your modified digestive system is functioning properly. Afterward, you will require periodic checkups. You will also need to take supplemental vitamins every day for the rest of your life to avoid developing nutritional deficiencies. As with other bariatric surgeries, you must maintain a healthy lifestyle that includes eating small nutritious meals and engaging in regular physical activity.
Risks and Complications
As with any major surgery, BPD/DS involves risks. These include internal bleeding, infection, hernias, anesthesia risks, and potentially fatal blood clots. Dr. Naim can minimize these risks through careful selection of candidates and post-surgical follow-ups. Other risks associated with BPD/DS include:
- Significant vitamin deficiencies. Careful attention to diet and supplements mitigates this risk. Regular blood tests are also necessary to monitor nutritional deficiencies.
- Long-term complications related to nutritional deficiencies, such as anemia, osteoporosis, and kidney stones.
- Gas, diarrhea, and foul-smelling bowel movements. An appropriate diet including the avoidance of “trigger foods” can help these problems.
Several studies have shown BPD/DS to be effective for patients with severe obesity. However, because of the complex nature of the operation, along with severely obese patients’ increased risk of surgical complications, it requires a surgeon with special skill and training.
BPD/DS can improve serious obesity-related health complications including diabetes, high cholesterol, high triglycerides, hyperlipidemia, and obstructive sleep apnea. Other benefits include:
- Reduced incidence of dumping syndrome as compared to gastric bypass surgery. Dumping syndrome is a group of symptoms that can occur after surgical removal of portions of the stomach.
- It involves a more normal diet that is better tolerated compared to diets required following other types of bariatric surgery.
- Since none of the intestine is removed, the malabsorbtive aspect of the surgery can be reversed, if necessary.