
Biliopancreatic Diversion-Duodenal Switch (BPD-DS) Surgery
Biliopancreatic Diversion-Duodenal Switch (BPD-DS) Surgery is an effective bariatric surgery designed for advanced weight loss and improvement of health problems. It both reduces the volume of the stomach and changes the digestive structure of the intestines, limiting the absorption of nutrients.
Biliopancreatic Diversion-Duodenal Switch (BPD/DS): A Comprehensive Guide
Biliopancreatic Diversion-Duodenal Switch (BPD/DS), commonly known as duodenal switch, is a complex bariatric surgery designed to achieve significant and long-lasting weight loss. This procedure combines sleeve gastrectomy with intestinal bypass to reduce calorie absorption and limit food intake. While BPD/DS is an effective method for weight loss, it requires a strong commitment to follow-up care due to the risk of nutrient deficiencies.
What is BPD/DS?
BPD/DS is a two-stage procedure:
- Sleeve Gastrectomy: The surgeon removes about 60-70% of the stomach, leaving a small tube-shaped section. This limits the amount of food that can be consumed at one time and creates an effect similar to a typical sleeve gastrectomy.
- Intestinal Bypass: The surgeon reconstructs the small intestine, disabling most of it. A short section is left where food mixes with digestive enzymes, which greatly reduces the absorption of calories, fat and nutrients.
The name “duodenal switch” comes from the fact that the bypass starts in the duodenum, the first section of the small intestine. This structure ensures that the pylorus, which controls the exit of the stomach, is protected and reduces the risk of dumping syndrome, a common problem with procedures such as gastric bypass.
Who is BPD/DS Suitable for?
BPD/DS is generally recommended for individuals with
- Patients with severe obesity with a BMI (Body Mass Index) of 50 and above.
- Individuals with a BMI of 40 or above and serious health conditions such as type 2 diabetes, heart disease or sleep apnea.
- Patients who fail to achieve adequate weight loss after sleeve gastrectomy.
Expected Weight Loss
Duodenal switch is one of the most effective methods for permanent weight loss. Most patients lose 60-80% of excess body weight within the first two years after surgery. Clinical studies show that 70% of excess body weight can be maintained even 10 years after surgery.
Benefits of BPD/DS
- Superior Weight Loss: BPD/DS offers the highest weight loss results among bariatric surgeries.
- Long Term Results: It is an effective method to maintain weight loss in the long term.
- Improvement in Health Problems: It is especially beneficial in solving obesity-related health problems such as type 2 diabetes, high cholesterol and high blood pressure.
- Preservation of Pylorus Function: Unlike other procedures, BPD/DS preserves the pylorus valve, which reduces the risk of dumping syndrome.
Risks and Cautions
While BPD/DS is an effective method, it carries some short and long-term risks:
- Nutritional Deficiencies: Reduced absorption of nutrients increases the risk of deficiencies of vitamins A, D, E, K and minerals such as calcium and iron. Lifelong supplementation is required.
- More Frequent and Loose Bowel Movements: Due to changes in digestion, patients may experience more frequent and loose stools, as well as increased gas.
- Malnutrition: In rare cases, protein-energy malnutrition may develop due to inadequate protein intake.
- Other Surgical Risks: Risks include infection, blood clots, internal bleeding and, in rare cases, death.
Postoperative Recovery and Care
After surgery, patients are closely monitored for complications. The recovery process involves starting with a liquid diet and slowly transitioning to soft and solid foods. Lifelong vitamin and mineral supplements are necessary to prevent nutrient deficiencies and patients need to monitor their nutritional status with regular blood tests.
ASMBS (Association for Metabolic and Bariatric Surgery) recommends the following supplements after BPD/DS
- Multivitamins containing 200% of the daily recommended value.
- Vitamin A, D, K and calcium supplements for a few weeks after surgery.
- Iron and B12 supplements for those at risk of anemia or menstruating women.
Maintaining a high-protein diet and regular medical check-ups are also crucial for long-term success.
Is BPD/DS Right for You?
BPD/DS may be an ideal solution for patients with severe obesity who have not had successful results with other weight loss methods. However, due to the risks of malnutrition and the complexity of the surgery, patients must adhere to a lifelong follow-up plan, dietary changes and supplementation program.
If you are considering BPD/DS surgery, you can talk to the experts at Istanbul Obesity Centerto find out if it is a suitable procedure for your health condition and weight loss goals.