Duodenal Switch Surgery

Duodenal Switch Surgery, also called biliopancreatic diversion with duodenal switch (BPD-DS) is the most powerful weight loss surgery to treat obesity.

The metabolic effect of duodenal switch is so effective that it results in a 99% cure rate for type 2 diabetes. In fact, most patients leave the hospital with reduced needs of insulin or oral hypoglycemic medication.

Although duodenal switch has been performed since 1985, is not as popular as gastric bypass or gastric sleeve because it is a highly technical operation to perform and combines two surgical methods to promote weight loss.

Ideal candidates for duodenal switch include individuals with a BMI > 60 kg/mor server diabetes.

Duodenal Switch Procedure

Duodenal switch surgery takes about 3-4 hours of operating time. The length of hospital stay is 2-3 nights. Patients generally take 3-4 weeks to recover before returning to work after having duodenal switch surgery.

How Duodenal Switch Works

Duodenal switch is similar to gastric sleeve in that most of the stomach containing the hunger-causing hormone Ghrelin is removed. The remaining portion of the stomach is stapled, creating a small narrow pouch (2-3 oz) that restricts the amount of food that can be eaten. This promotes weight loss.

  • The malabsorptive component of the surgery involves bypassing a portion of the small intestine, but keeps the pyloric valve in tact.
  • Food bypasses 40-65% of the small intestine, greater than in gastric bypass.
  • This results in the body absorbing fewer calories and nutrients from food (malabsorption), creating additional weight loss.

Duodenal Switch and Diabetes

The metabolic effect of duodenal switch surgery is so powerful that many patients with type 2 diabetes have a reduced need for insulin or oral hypoglycemic medicine immediately after surgery.

  • It also explains why there is a 99% cure rate for type 2 diabetes after duodenal switch surgery.

Duodenal Switch Benefits

One of the primary advantages of this procedure is that the stomach function remains intact and continues to digest food normally after surgery. Other benefits of duodenal switch can include:

  • 80-90% average excess weight loss – most powerful weight loss operation, site references
  • 99% cure rate in diabetes – most effective surgery for improving or eliminating diabetes
  • Rapid weight loss at an average of 5+ pounds per week
  • Removes hunger-causing hormones resulting in less hunger
  • No dumping syndrome as in gastric bypass surgery
  • Results in greatest resolution of other obesity-related conditions (sleep apnea, high blood pressure and hypertension)

Duodenal Switch Considerations, Risks

  • Designed for patients (over 400 pounds with severe diabetes) where other surgical procedures may not be effective.
  • The surgery is highly technical and not many bariatric surgeons offer the surgery.
  • Stomach removal is permanent, but the intestinal bypass may be reversed.
  • Potential complications include intestinal blockage, diarrhea, protein and vitamin deficiencies.
  • Requires lifetime use of vitamin supplements and foods
  • Abdominal bloating and foul-smelling stool or gas can occur
  • Potential intestinal irritation and ulcers
  • Changes to the intestinal structures can increase the risk of gallstones.

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