Duodenal Switch is similar to biliopancreatic diversion bypass, or BPD, but instead of a small stomach pouch, a sleeve-shaped stomach is made. The surgeon attaches the final section of the small intestine into the stomach sleeve. Duodenal switch has the same result as other stomach bypass surgeries: bypassing the rest of the small intestine resulting in less absorption of calories and nutrients, causing the feeling of being full.
Biliopancreatic diversion with duodenal switch (BPD-DS)
The duodenal switch, or BPD-DS, is a complex bariatric procedure and is considered a bigger operation than simple gastric bypass. A large amount of the lower stomach, about half, is permanently and irreversibly removed. The remaining top portion of the stomach is stapled or sutured and formed into the shape and size of a banana.
Much of the small intestine is rerouted, forming two separate pathways and one common channel. The shorter pathway routes food from the stomach to the common channel. The longer pathway carries bile to the common channel. In the common channel, the contents from the stomach mix with the bile before traveling to the large intestine. The purpose of this design is to reduce the absorption of fat and limit the time the body has to draw calories from food.
Duodenal switch advantages
Patients are able to eat larger portions than other bypass surgeries because of a larger stomach size and the pylorus, a stomach valve located at the bottom of the stomach, usually bypassed by other bariatric surgeries, remains intact. The intact pylorus also eliminates the possibly of ulcers, blockages, and dumping syndrome, a condition in which the stomach empties its contents into the small intestine too quickly, causing cramping and nausea, ulcers, and blockages. Food is able to digest normally and sustain more nutrients because of the preservation of the pylorus and duodenum.
Duodenal switch risks
Since a large section of small intestine is bypassed, substantial malabsorption can occur, causing an increased risk of long-term nutritional deficits. Nutritional supplements like multivitamins, iron, and calcium are important after surgery. In addition to nutritional deficiencies, the following risks could occur:
- Frequent soft bowel movements
- Foul smelling flatulence, gas pains, bloating
- Change in body odor
- Hair loss
- Intolerance of certain foods
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