Skip to main content

Biliopancreatic Diversion with Duodenal Switch: Technique and Outcomes

  • Chapter
  • First Online:
Book cover The ASMBS Textbook of Bariatric Surgery

Abstract

Biliopancreatic diversion with duodenal switch (BPD/DS) is a less commonly performed but very effective operation. It is now being performed more frequently than before as a primary option for those patients who need to lose a lot of weight or have severe diabetes or hypercholesterolemia. It is also a good salvage operation for inadequate results after other bariatric operations or for high-risk patients as a staged approach. Minimally invasive techniques for performing the operation are now well described. The BPD/DS is associated with higher technical difficulty and more nutritional deficiencies, but these can be managed by an experienced team.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Scopinaro N, Gianetta E, Civalleri D, Bonalumi U, Bachi V. Bilio-pancreatic bypass for obesity: 1. An experimental study in dogs. Br J Surg. 1979;66(9):613–7.

    Article  CAS  Google Scholar 

  2. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8(3):267–82.

    Article  CAS  Google Scholar 

  3. 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.

    Article  CAS  Google Scholar 

  4. 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):514–23; discussion 24.

    Article  CAS  Google Scholar 

  5. Sudan R, Puri V, Sudan D. Robotically assisted biliary pancreatic diversion with a duodenal switch: a new technique. Surg Endosc. 2007;21(5):729–33.

    Article  CAS  Google Scholar 

  6. Sudan R, Maciejewski ML, Wilk AR, Nguyen NT, Ponce J, Morton JM. Comparative effectiveness of primary bariatric operations in the United States. Surg Obes Relat Dis. 2017;13(5):826–34.

    Article  Google Scholar 

  7. English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259–63.

    Article  Google Scholar 

  8. Aminian A, Andalib A, Khorgami Z, Cetin D, Burguera B, Bartholomew J, et al. Who should get extended thromboprophylaxis after bariatric surgery?: a risk assessment tool to guide indications for post-discharge pharmacoprophylaxis. Ann Surg. 2017;265(1):143–50.

    Article  Google Scholar 

  9. Thorell A, MacCormick AD, Awad S, Reynolds N, Roulin D, Demartines N, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) society recommendations. World J Surg. 2016;40(9):2065–83.

    Article  CAS  Google Scholar 

  10. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient – 2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27.

    Article  CAS  Google Scholar 

  11. Sudan R, Kasotakis G, Betof A, Wright A. Sleeve gastrectomy strictures: technique for robotic-assisted strictureplasty. Surg Obes Relat Dis. 2010;6(4):434–6.

    Article  Google Scholar 

  12. Aasheim ET, Bjorkman S, Sovik TT, Engstrom M, Hanvold SE, Mala T, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15–22.

    Article  Google Scholar 

  13. Binggeli C, Corti R, Sudano I, Luscher TF, Noll G. Effects of chronic calcium channel blockade on sympathetic nerve activity in hypertension. Hypertension. 2002;39(4):892–6.

    Article  CAS  Google Scholar 

  14. Bloomberg RD, Fleishman A, Nalle JE, Herron DM, Kini S. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.

    Article  Google Scholar 

  15. Dolan K, Hatzifotis M, Newbury L, Lowe N, Fielding G. A clinical and nutritional comparison of biliopancreatic diversion with and without duodenal switch. Ann Surg. 2004;240(1):51–6.

    Article  Google Scholar 

  16. Rudnicki SA. Prevention and treatment of peripheral neuropathy after bariatric surgery. Curr Treat Options Neurol. 2010;12(1):29–36.

    Article  Google Scholar 

  17. Salle A, Demarsy D, Poirier AL, Lelievre B, Topart P, Guilloteau G, et al. Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg. 2010;20(12):1660–70.

    Article  Google Scholar 

  18. Slater GH, Ren CJ, Siegel N, Williams T, Barr D, Wolfe B, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg. 2004;8(1):48–55; discussion 4–5.

    Article  Google Scholar 

  19. Sovik TT, Taha O, Aasheim ET, Engstrom M, Kristinsson J, Bjorkman S, et al. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Br J Surg. 2010;97(2):160–6.

    Article  CAS  Google Scholar 

  20. Marceau P, Biron S, Hould FS, Lebel S, Marceau S, Lescelleur O, et al. Duodenal switch improved standard biliopancreatic diversion: a retrospective study. Surg Obes Relat Dis. 2009;5(1):43–7.

    Article  Google Scholar 

  21. Prachand VN, Davee RT, Alverdy JC. Duodenal switch provides superior weight loss in the super-obese (BMI > or =50 kg/m2) compared with gastric bypass. Ann Surg. 2006;244(4):611–9.

    PubMed  PubMed Central  Google Scholar 

  22. Biertho L, Biron S, Hould FS, Lebel S, Marceau S, Marceau P. Is biliopancreatic diversion with duodenal switch indicated for patients with body mass index <50 kg/m2? Surg Obes Relat Dis. 2010;6(5):508–14.

    Article  Google Scholar 

  23. Marceau P, Hould FS, Lebel S, Marceau S, Biron S. Malabsorptive obesity surgery. Surg Clin North Am. 2001;81(5):1113–27.

    Article  CAS  Google Scholar 

  24. Sudan R, Podolsky E. Totally robot-assisted biliary pancreatic diversion with duodenal switch: single dock technique and technical outcomes. Surg Endosc. 2015;29(1):55–60.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ranjan Sudan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sudan, R. (2020). Biliopancreatic Diversion with Duodenal Switch: Technique and Outcomes. In: Nguyen, N., Brethauer, S., Morton, J., Ponce, J., Rosenthal, R. (eds) The ASMBS Textbook of Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-27021-6_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-27021-6_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27020-9

  • Online ISBN: 978-3-030-27021-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics