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Lap Biliopancreatic Diversion Sydney

LAP BILIOPANCREATIC DIVERSION SYDNEY
The duodenal switch is also known as Biliopancreatic diversion with duodenal switch or Gastric reduction duodenal switch. This weight loss surgery procedure is composed of a restrictive and a malabsorptive aspect, and is a popular Bariatric surgery technique. The restrictive portion of the surgery involves removing approximately 70% of the stomach. The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel.

This operation combines removal or exclusion of 2/3rds of  the stomach along with a long intestinal bypass which significantly reduces the absorption of fat. The capacity to eat is greater than with the other operations, and the eventual weight loss is the best of all the operations but if fatty foods are overeaten e.g. a hamburger and fries then diarrhoea and foul flatus will result.

Lap Biliopancreatic Diversion Advantages

  • Greater stomach capacity (200-250 mls) therefore can eat a small main meal instead of an entrée portion
  • Best weight loss of all techniques 70-90% EWL over 2yrs
  • Weight loss is well maintained
  • Adjustable and partially reversible, but only by further surgery
  • A very good option for revision if other techniques have failed

Lap Biliopancreatic Diversion Disadvantages

  • Open operation (usually), therefore greater operative risks e.g infection, Bowel leak, Clots to legs and lungs wound infection and hernia, chest infection. Risk of Death 1:200
  • Malabsorbtion to some minerals vitamins and Protein . Patients must commit to taking lifelong supplements of the fat soluble vitamins ( A D E K ) Calcium and sometimes Iron
  • Risk of deficiency state e.g. Iron deficiency anaemia or osteoporosis if supplements not taken
  • Take longer to recover (6-8 weeks off work)
  • Increased stool frequency 2-4/day
  • Flatulance if fatty foods eaten

Residual stomach capacity 200mls and Estimated weight loss is 70-90%EWL at 2 years.