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BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH:

Biliopancreatic Diversion

There are different types of weight-loss surgeries carried out worldwide to cure obesity. Since obesity is a morbid disease, it brings other disorders with it over time. Such as diabetes, hypertension, cardiovascular diseases etc. Hence it is very important to get rid of it as soon as possible.

Various bariatric procedures are there for the rescue. Among all the bariatric surgery procedures, Biliopancreatic diversion with duodenal switch (BPD DS) is also included. It is an advanced surgical intervention for morbid obesity. Let’s get into detail about this obesity treatment option.

WHAT IS BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH?

In easy words, we explain this as a digestive system surgery. If we look closely, we have two different words here. Biliopancreatic diversion and the other, duodenal switch. These are two different steps of this surgery that contribute to the whole long-term outcome.

During the BPD DS procedure, a portion of your stomach is removed. The other portion (smaller one) is then attached to the end part of the small intestine called the ileum by connecting it to the duodenum. It is the duodenal switch. This reduces the size of your stomach resulting in the restriction on the amount of food you eat. In this way, your body absorbs a limited amount of calories and nutrients.

Coming to the biliopancreatic diversion. The part of your stomach that was removed, is not thrown away. It is reconnected to the last part of the small intestine called the ileum. This connection diverts the normal way of secretion of bile (digestive juice from the liver) and pancreatic juices. Therefore, it is named biliopancreatic diversion.

According to the University of Rochester Medical Centre, biliopancreatic diversion with duodenal switch results in more weight loss than average sleeve gastrectomy or gastric bypass.

HOW BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH IS PERFORMED?

This surgery can be performed with laparoscopic techniques as well as by open surgery.

During a laparoscopic procedure, the surgeon makes several small cuts or incisions on your abdominal area. Then a thin wire along with a fine camera is inserted through that cut. As the camera keeps showing the inside of your stomach, the bariatric surgeon performs the surgery. It is done either manually or with the assistance of robotic tools.

In open surgery, instead of smaller cuts, the surgeons make a bigger incision on your abdomen. Then with their expertise, they perform the whole surgery.

Pre-Operative Measures:

Before the surgery starts, every possible testing is made out. Your blood pressure, blood sugar level, ECG etc is monitored to make sure your body is perfect to undergo surgery.

Then you are given the right amount of anesthesia. It blocks the sensation of pain.

The patient is placed in a split leg position and then secured with tapes and straps to avoid any movement.

Post-Operative Measures:

After a successful surgery, you wake up in the recovery room. Your healthcare team will tell you specific post-operative measures that you have to strictly follow.

After biliopancreatic diversion with a duodenal switch, you may come across severe vitamin deficiencies. So you have to keep track of your vitamin and mineral supplements. They include Vitamins A, D, E and K. Iron and Calcium deficiency supplements. They may also include supplements for vitamin B-12.

After your surgery, the health care professionals will provide you with some dietary changes. You have to follow this diet strictly. It’s because, after surgery, it is common for the patients to feel mild health problems. They are because of the changes made in the body. So, the meal plan provided by your physician holds value. You have to follow it to be cured completely.

HEALTH COMPLICATIONS AND RISKS OF BILIOPANCREATIC DIVERSION:

Biliopancreatic diversion with a duodenal switch is a surgery that is not performed very often. It has its risks and complications depending upon the patient experiences that you need to know.

ANASTOMOTIC LEAK:

According to the National Institute of Health, The incidence of a gastric or duodenal leak following biliopancreatic diversion with duodenal switch is 1.14% vs. 1.12% for Roux en-Y gastric bypass.

This leakage is traced through CT scans and oral IV contrasts to determine the severity. If it’s very acute, then the patient is operated again.

HAEMORRHAGE:

It is a postoperative risk of biliopancreatic diversion surgery. It is not very common though, but it needs to be monitored. According to the National Institute of Health, The reported incidence of a postoperative hemorrhage is less than 1% of all gastric bypass surgeries that experience bleeding, which requires intervention or transfusion.

NUTRITIONAL DEFICIENCIES:

As mentioned earlier, patients do experience various vitamin and nutritional deficiencies after their biliopancreatic diversion surgery. So Doctors prescribe medications according to your body’s needs and their expertise. So you have to follow what they recommend.

AM I ELIGIBLE FOR BILIOPANCREATIC DIVERSION WITH DUODENAL SWITCH SURGERY:

If you want to get rid of obesity and consider weight loss surgeries, make sure that you are eligible enough to go through the surgery.

These are some eligibility criteria for weight loss surgeries, especially biliopancreatic diversion:

According to the American Society for Metabolic and Bariatric surgery, if you have body mass index (BMI)> or = 35 or BMI> or = 40, you are highly eligible for bariatric surgery. You also need to have at least 1 comorbid disease along with obesity such as cardiovascular disorder or hypertension etc.

If you have a BMI>50, you are highly recommended for biliopancreatic diversion surgery.

If you are pregnant then do not look for bariatric surgery. You are not eligible for that.

If you have any serious psychiatric illness such as substance-use disorder or eating disorders, do not look for weight loss surgery. 

KEY TAKEAWAYS:

Weight-loss or bariatric surgeries are highly effective to cure obesity. But they carry some risk factors along with them too.

If you are fighting obesity, we recommend having surgery for that if you’re eligible enough. After thoroughly considering every point of bariatric surgery, appoint one.

Weight-loss surgeries are malabsorptive in nature. It means that you are restricted to a certain amount of food. We have a team of highly professional and expert bariatric surgeons who make sure to give you proper treatment and recommendations for your weight-loss journey.

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