Duodenal switch
- The Duodenal Switch (also known as Bilio-Pancreatic Diversion with Duodenal Switch) procedure is a weight loss surgery that alters the gastrointestinal tract with two approaches: a restrictive aspect and a malabsorptive aspect.
- The restrictive portion of the surgery reduces the stomach along the greater curvature so that the volume is approximately one third its original. The maladaptive portion of the surgery reroutes a large portion of the small intestine, creating two separate pathways and one common pathway. The shorter of the two pathways, the digestive loop, takes food from the stomach to the large intestine. The by-far longer pathway, the bilio-pancreatic loop, diverts bile from the liver to the common path. The common path is a stretch of small intestine, approximately 75–100 centimeters long, in which the contents of the digestive path mix with the bile from the bilio-pancreatic loop before emptying into the large intestine. The point of this arrangement is to reduce the amount of time the body has to capture nutrients and calories from food in the small intestine as well as severely limit the absorption of fat.
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Advantages
- The main advantage of the Duodenal Switch (DS) surgery is that by using two approaches, weight loss tends to be achieved more quickly and more permanently.
- Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the DS do not experience the Dumping syndrome common with people who've undergone the Roux-en-Y gastric bypass surgery.
- Those who undergo the DS often find that comorbidities such as Dumping syndrome (high blood pressure), Diabetes mellitus type 2, and Arthritis are significantly relieved in a short time after the surgery.
- Some surgeons are so confident in the benefits of the DS that they will accept super-morbidly obese patients, who are often turned down for other weight loss surgeries.
Disadvantages
- The malabsorptive element of the DS is so potent that those who undergo the procedure must take vitamin and mineral supplements above and beyond that of the normal population. Those that do not run the risk of deficiency diseases such as anemia and osteoporosis.
- Because gallstones are a common complication of the DS, most surgeons now remove the gall bladder during the surgery.
- Far fewer surgeons perform the DS compared to other weight loss surgeries.
Qualifications
- The National Institutes of Health state that if you meet the following guidelines, weight loss surgery may be an appropriate measure for permanent weight loss
- BMI of 40 or over
- BMI of 35 or over with serious obesity-related illnesses such as:
- An understanding of the operation and lifestyle changes necessary following the surgery.
Effectiveness
The following statistics are taken from Pacific Laproscopy and Duodenal Switch Information Zone.
- Weight loss:
- 3 months – 29 and 37%
- 6 months – 51 and 55%
- 24 months – 91 and 80%