This is the most effective bariatric/ metabolic surgery since hormonal changes are very high. Gastric sleeve is formed using staplers. First part of small intestine (duodenum) is disconnected and attached todistal ileum (Last part of small intestine) in a Roux en y fashion.
Hormonal and genetic changes responsible for long lasting weight loss and durable diabetes remission are very high in BPD DS compared to sleeve gastrectomy, roux en y gastric bypassor mini gastric bypass – one anastomosis gastric bypass. So weight loss is more effective & long lasting and diabetes remission is more& durable. Chances of weight regain and diabetes recurrence are very low. If anyone regains weight after sleeve gastrectomy or gastric bypass, revision to duodenal switch induces further hormonal changes necessary for weight loss and diabetes remission.
Since most of the small intestine is bypassed, risk of protein energy malnutrition, malabsorption, vitamin and mineral deficiencies are very high after BPD DS. Patients can develop foul smelling sticky stools, diarrhea and incontinence after BPD DS as fat is not absorbed. There is risk of formation of renal stones. Single anastomosis duodenoileal bypass with sleeve (SADI S) is a loop modification of BPD DS. This modification reduces malabsorption without compromising efficacy of surgery
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Laparoscopic biliopancreatic diversion with duodenal switch
(Drawn by Dr. V. Amar)
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