Biliopancreatic Diversion with Duodenal Switch Dallas (BPD/DS) Gastric Bypass


The Biliopancreatic Diversion with Duodenal Switch Dallas  – abbreviated as BPD/DS – is a procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy.

The Procedure

The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. Roughly three-fourths of the small intestine is bypassed by the food stream.
Lastly, the BPD/DS, similar to the gastric bypass and sleeve gastrectomy, affects guts hormones in a manner that impacts hunger and satiety as well as blood sugar control. The BPD/DS is considered to be the most effective surgery for the treatment of diabetes among those that are described here.

Advantages

1.    Results in greater weight loss than RYGB, LSG, or AGB, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up
2.    Allows patients to eventually eat near “normal” meals
3.    Reduces the absorption of fat by 70 percent or more
4.    Causes favorable changes in gut hormones to reduce appetite and improve satiety
5.    Is the most effective against diabetes compared to RYGB, LSG, and AGB

Disadvantages

1.    Has higher complication rates and risk for mortality than the AGB, LSG, and RYGB
2.    Requires a longer hospital stay than the AGB or LSG
3.    Has a greater potential to cause protein deficiencies and long-term deficiencies in a number of vitamin and minerals, i.e. iron, calcium, zinc, fat-soluble vitamins such as vitamin D
4.    Compliance with follow-up visits and care and strict adherence to dietary and vitamin supplementation guidelines are critical to avoiding serious complications from protein and certain vitamin deficiencies


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