26 August 2008

The biliopancreatic diversion with duodenal switch goes by many names. The National Institutes of Health refers to the procedure as an "extensive gastric bypass with duodenal switch." While less commonly performed than the gastric bypass, this operation has received a great deal of attention recently, particularly on the internet, because it provides excellent weight loss while allowing you to eat larger portions than a gastric bypass.

The BPD/DS combines restrictive and malabsorptive elements to achieve and maintain the best reported long-term percentage of excess weight loss among modern weight-loss surgery procedures.

In the BPD/DS, roughly one half of the stomach is permanently removed. The stomach goes from the shape of a small pineapple to the size and shape of a banana. The pylorus, which is the valve at the outlet of the stomach, remains intact. The stomach is then connected to the last 250 centimeters (8 feet) of small intestine. The remainder of the small intestine is connected 100 centimeters from the end of the small bowel, forming the common channel, where food mixes with the digestive enzymes.

Unlike the unmodified BPD and RNY, which both employ a gastric “pouch” and bypass the pyloric valve, the DS procedure keeps the pyloric valve intact. This eliminates the possibility of dumping syndrome, marginal ulcers, stoma closures and blockages, all of which can occur after other gastric bypass procedures. The DS procedure keeps a portion of the duodenum in the food stream. The preservation of the pylorus/duodenum pathway means that food is digested normally (to an optimally absorbable consistency) in the stomach before being excreted by the pylorus into the small intestine. As a result, the DS procedure enables more-normal absorption of many nutrients (including protein, calcium, iron and vitamin B12) than is seen after other gastric bypass procedures.

The BPD-DS Major Advantages
  • The pylorus remains intact: this usually keeps dumping syndrome from occurring after surgery (although you may have different dietary restrictions)
  • Since the stomach pouch is larger than with other bariatric operations, you can eat larger portions than with the gastric bypass or LAP-BAND®.

Living with the BPD-DS
It is necessary to take a number of nutritional supplements after the operation than after gastric bypass. These include:
  • Multivitamins (usually twice per day)
  • Iron supplements (usually twice per day)
  • Calcium (usually twice per day)
  • ADEKs (fat-soluble vitamins) usually 3 times per day

Side Effect of BPD-DS
Additionally, there are some very significant side effects that accompany this procedure, including:
  • Frequent soft bowel movements (up to 4-6 per day)
  • Frequent passing of foul-smelling gas
  • Change in body odor
  • Gas pains and bloating
  • Hair loss
  • ntolerance of certain foods (varies from person to person)


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