Duodenal Switch, also known as biliopancreatic diversion with duodenal switch (BD/DS), is a weight loss surgical procedure consisting of a restrictive and a malabsorptive component. The objective of the surgery is to alter the anatomy of a patients body, restricting the bodys fat absorption and calorie intake.
The restrictive component includes partial gastrectomy whereby a significant portion of the stomach is removed along its greater curvature. This greatly reduces the stomach’s capacity to store food, without affecting its functionality. While performing the duodenal switch surgery, the pyloric valve is kept intact. This eliminates the possibility of various digestive complications, such as dumping syndrome, stomach blockages and ulcers. Furthermore, a portion of the duodenum is also kept in the food stream, resulting in improved absorption of essential nutrients, as compared to other weight loss surgical procedures.
The malabsorptive component is where the arrangement of the small intestine is altered. The small intestine is divided into two separate pathways, leading into a common channel. This is to separate the flow of food from the bile and pancreatic juices, inhibiting calories absorption. When the two pathways join in the common channel, the food and digestive juices mix, however, only a limited amount of fat is absorbed as the food continues to move towards the larger intestine.
Due to its unique combination of the restrictive and malabsorptive components, duodenal switch results in immediate weight loss, while also reducing the chances of significant weight regain. This procedure is also known to cure diabetes, particularly type 2, in diabetic patients. More interesting is the fact that duodenal switch is also being performed on non-obese patients in Europe because of its extremely positive effect on diabetic patients.
Furthermore, as stated above, because the pyloric valve and duodenum are kept intact, the duodenal switch procedure has far less adverse consequences as compared to Roux-en-Y gastric bypass surgery (R.N.Y). Also, the diets that are to be followed after the procedure are quite easy to carry on. In addition to that, the malabsorptive component of this procedure is completely reversible.
Something worth getting concerned over is that the duodenal switch procedure results in certain lifelong changes. The restrictive component of duodenal switch procedure is irreversible, nevertheless, the stomach does retain some of its size overtime. After the duodenal switch procedure, the patients have to compulsorily go for routine checkups for the rest of their lives, getting tested for life essential vitamins and nutrients deficiencies. As with other weight loss procedures, duodenal switch also poses a risk of developing gallstones. It is also common for DS patients to complain of smelly diarrhea and gas problems.
In order to qualify for duodenal switch procedure, certain standards, as set by the National Health Institute, are to be met first. These are, having a Body Mass Index of over 39, or over 34 if you suffer from obesity related illnesses (to calculate your BMI: With respect to children and adolescents, it is not advised to carry out the duodenal switch surgery because of inadequate studies regarding consequences of duodenal switch surgery on them.
On an end note, it is important to realize that a weight loss procedure such as the duodenal switch has life-long effects and, therefore, you should get professional medical advice before having this procedure performed on yourself.