Laparoscopic Biliopancreatic Diversion with Duodenal Switch

  • Ronald Matteotti
  • Michel Gagner


The jejunoileal bypass was the first malabsorptive procedure performed and the only available bariatric procedure in earlier times. First performed in 1953 by Varco and Kremen, it dominated the bariatric field over 20 years (1). The procedure consisted of an end-to-end jejunoileostomy with a separate ileocecostomy for drainage of the bypassed segment. Excellent weight loss was seen, but major complications such as gas-bloat syndrome, diarrhea, changes in electrolytes, impaired mental status, nephrolithiasis, eruptive integument lesions, and hepatic fibrosis and failure occurred. Because of these serious complications, this procedure was not used routinely (1).


Sleeve Gastrectomy Laparoscopic Adjustable Gastric Banding Excessive Weight Loss Biliopancreatic Diversion Duodenal Switch 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Buchwald H, Rucker RD. The rise and fall of jejunoileal bypass. Norwalk, CT: Appleton Century Croft, 1987.Google Scholar
  2. 2.
    Payne JH, DeWind LT, Commons RR. Metabolic observations in patients with jejunocolic shunts. Am J Surg 1986; 106:272–289.Google Scholar
  3. 3.
    Payne JH, DeWind LT. Surgical treatment of obesity. Am J Surg 1969;118(2):141–147.CrossRefPubMedGoogle Scholar
  4. 4.
    Deitel M. Jejunocolic and jejunoileal bypass: an historical perspective. In: Deitel M, ed. Surgery for the Morbidly Obese Patient. Philadelphia: Lea & Febiger, 1998:81–89.Google Scholar
  5. 5.
    Lewis LA, Turnbull RB Jr, Page IH. Effects of jejunocolic shunt on obesity, serum lipoproteins, lipids, and electrolytes. Arch Intern Med 1966;117(1):4–16.CrossRefPubMedGoogle Scholar
  6. 6.
    Scott HW Jr, Sandstead HH, Brill AB, Burko H, Younger RK. Experience with a new technic of intestinal bypass in the treatment of morbid obesity. Ann Surg 1971;174(4):560–572.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Salmon PA. The results of small intestine bypass operations for the treatment of obesity. Surg Gynecol Obstet 1971; 132(6):965–979.PubMedGoogle Scholar
  8. 8.
    Buchwald H, Varco RL. A bypass operation for obese hyperlipidemic patients. Surgery 1971;70(1):62–70.PubMedGoogle Scholar
  9. 9.
    Palmer JA. The present status of surgical operation for obesity. In: Deitel M, ed. Nutrition in Clinical Surgery. Baltimore: Williams & Wilkins, 1980:281–292.Google Scholar
  10. 10.
    Kral JG. Duodenoileal bypass. In: Deitel M, ed. Surgery for the Morbidly Obese Patient. Philadelphia: Lea & Febiger, 1998:99–103.Google Scholar
  11. 11.
    Cleator IG, Gourlay RH. Ileogastrostomy for morbid obesity. Can J Surg 1988;31(2):114–116.PubMedGoogle Scholar
  12. 12.
    Forestierie P, DeLuca L, Bucci L. Surgical treatment of high degree obesity. Our own criteria to choose the appropriate type of jejuno-ileal bypass: a modified Payne technique. Chir Gastroenterol 1977;11:401–408.Google Scholar
  13. 13.
    Starkloff GB, Stothert JC, Sundaram M. Intestinal bypass: a modification. Ann Surg 1978;188(5):697–700.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Lavorato F, Doldi SB, Scaramella R. Evoluzione storica della terapia chirurgica della grande obesita. Minerva Med 1978;69:3847–3857.PubMedGoogle Scholar
  15. 15.
    Eriksson F Biliointestinal bypass. Int J Obes 1981;5(4): 437–447.PubMedGoogle Scholar
  16. 16.
    Scopinaro N, Gianetta E, Civalleri D, Bonalumi U, Bachi V. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg 1979;66(9):618–620.CrossRefPubMedGoogle Scholar
  17. 17.
    Marceau P, Biron S, Bourque RA, Potvin M, Hould FS, Simard S. Biliopancreatic diversion with a new type of gastrectomy. Obes Surg 1993;3(1):29–35.CrossRefPubMedGoogle Scholar
  18. 18.
    Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–282.CrossRefPubMedGoogle Scholar
  19. 19.
    de Csepel J, Burpee S, Jossart G, et al. Laparoscopic biliopancreatic diversion with a duodenal switch for morbid obesity: a feasibility study in pigs. J Laparoendosc Adv Surg Tech A 2001;11(2):79–83.CrossRefPubMedGoogle Scholar
  20. 20.
    Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 2000;10(6):514–523; discussion 524.CrossRefPubMedGoogle Scholar
  21. 21.
    Kim WW, Gagner M, Kini S, et al. Laparoscopic vs. open biliopancreatic diversion with duodenal switch: a comparative study. J Gastrointest Surg 2003;7(4):552–557.CrossRefPubMedGoogle Scholar
  22. 22.
    Baltasar A, Bou R, Miro J, Bengochea M, Serra C, Perez N. Laparoscopic biliopancreatic diversion with duodenal switch: technique and initial experience. Obes Surg 2002; 12(2):245–248.CrossRefPubMedGoogle Scholar
  23. 23.
    Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg 1998;22(9):947–954.CrossRefPubMedGoogle Scholar
  24. 24.
    Paiva D, Bernardes L, Suretti L. Laparoscopic biliopancreatic diversion: technique and initial results. Obes Surg 2002;12(3):358–361.CrossRefPubMedGoogle Scholar
  25. 25.
    Scopinaro N, Marinari GM, Camerini G. Laparoscopic standard biliopancreatic diversion: technique and preliminary results. Obes Surg 2002;12(3):362–365.CrossRefPubMedGoogle Scholar
  26. 26.
    Rabkin RA, Rabkin JM, Metcalf B, Lazo M, Rossi M, Lehmanbecker LB. Laparoscopic technique for performing duodenal switch with gastric reduction. Obes Surg 2003; 13(2):263–268.CrossRefPubMedGoogle Scholar
  27. 27.
    Dolan K, Fielding G. Bilio pancreatic diversion following failure of laparoscopic adjustable gastric banding. Surg Endosc 2004;18(1):60–63.CrossRefPubMedGoogle Scholar
  28. 28.
    Resa JJ, Solano J, Fatas JA, et al. Laparoscopic biliopancreatic diversion: technical aspects and results of our protocol. Obes Surg 2004;14(3):329–333; discussion 333.CrossRefPubMedGoogle Scholar
  29. 29.
    Slater GH, Fielding GA. Combining laparoscopic adjustable gastric banding and biliopancreatic diversion after failed bariatric surgery. Obes Surg 2004;14(5):677–682.CrossRefPubMedGoogle Scholar
  30. 30.
    Weiner RA, Blanco-Engert R, Weiner S, Pomhoff I, Schramm M. Laparoscopic biliopancreatic diversion with duodenal switch: three different duodeno-ileal anastomotic techniques and initial experience. Obes Surg 2004;14(3): 334–340.CrossRefPubMedGoogle Scholar
  31. 31.
    Anthone GJ, Lord RV, DeMeester TR, Crookes PF. The duodenal switch operation for the treatment of morbid obesity. Ann Surg 2003;238(4):618–627; discussion 627–628.PubMedCentralPubMedGoogle Scholar
  32. 32.
    Paiva D, Bernardes L, Suretti L. Laparoscopic biliopancreatic diversion for the treatment of morbid obesity: initial experience. Obes Surg 2001;11(5):619–622.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Ronald Matteotti
    • 1
  • Michel Gagner
    • 1
  1. 1.Department of SurgeryWeill Medical College of Cornell University, New York-Presbyterian HospitalNew YorkUSA

Personalised recommendations