Biliopancreatic Diversion and Duodenal Switch

The biliopancreatic diversion is widely used in Europe. The duodenal switch is a US adaptation of the biliopancreatic diversion and is gaining popularity in the US. Both procedures involve a partial gastrectomy leaving a gastric pouch, which is considerably larger than that of gastric bypass or the restrictive procedures. The procedures permit larger meals in comparison to other bariatric procedures.

Weight loss after biliopancreatic diversion and duodenal switch is about 70% of the excess body weight. Potential long-term complications include diarrhea, vitamin, mineral, and nutrient deficiencies. Additionally, dumping syndrome is possible with the biliopancreatic diversion.

These are long and difficult procedures requiring skilled surgeons with adequate experience. When performed by skilled surgeons, operative mortality rate is about 1.0%.