Duodenal Switch Surgery - Basics
Duodenal switch surgery, also known as biliopancreatic diversion with duodenal switch (BPD-DS) or gastric reduction duodenal switch (GRDS), has been performed since 1985 but is less common because it is a technically difficult operation to perform and has a higher level of risk.
How the duodenal switch works: Similar to the sleeve gastrectomy, most of the stomach and cells containing Ghrelin are removed, thereby reducing one’s appetite. The remaining portion of the stomach is stapled off, creating a 2-4 ounce pouch. Stretch and pressure receptor nerves as well as the upper (LES) and lower (pylorus) valves remain intact in the newly created pouch which may lead to a longer lasting feeling of fullness. The pouch is then connected to the enteric limb, diverting food and preventing it from mixing with digestive juices. Food bypasses 40-60% of the small intestine—greater than in gastric bypass—resulting in increased malabsorption and potentially greater weight loss.
Duodenal Switch - Ideal Candidate
- Has BMI >60 kg/m2 or severe diabetes
- Poorly controlled diabetic or insulin-dependent diabetic has the highest cure rate with this procedure
Duodenal Switch - Benefits
- Most powerful weight loss operation; average excess weight loss 80-90%
- Most effective procedure for improving or eliminating diabetes
- 3-4 hour procedure with 1-2 night hospital stay
- Recovery time ranges from a few days to several weeks
- Patients report longer lasting fullness
- Stomach resection may reduce hunger by eliminating hunger-causing hormones
- Approximately 200-400 calories may be lost through malabsorption
- Some insurance may cover procedure if deemed medically necessary to mitigate comorbid health problems
Duodenal Switch - Considerations / Risks
- Offered only to patients for whom other procedures may not be effective (e.g. patients over 400 pounds or with severe diabetes)
- Procedure is highly technical; not offered by many surgeons due to the high level of technical skill required and higher level of risks
- Preoperative weight loss is critical to help complete the operation laparoscopically
- Stomach removal is permanent; intestinal bypass may be reversed
- Potential complications include diarrhea, protein and vitamin deficiencies, and intestinal blockages (can be easily managed if they do occur)
- Early risks of the procedure can be minimized; modified intestinal bypass can decrease risk of associated bypass risks
Duodenal Switch Surgery and Diabetes
The metabolic effect of duodenal switch surgery is the reason that some patients with type 2 diabetes leave the hospital after their DS surgery with reduced needs of insulin or oral hypoglycemic medicine. It also explains why there is a 99% cure rate for type 2 diabetes following the duodenal switch procedure.
Patient Profile
Read about Karen's patient experience with the duodenal switch procedure.
About Sutter Pacific Medical Foundation
Consult a Top Bariatric Surgeon
Sutter Pacific Medical Foundation, part of the Sutter Health network, offers bariatric surgery for weight loss. Our team performs surgery at California Pacific Medical Center (CPMC). Procedures include gastric bypass, gastric banding with LAP-BAND® or REALIZE® and stomach stapling procedures. Our weight loss surgeon performs bariatric, gastroenterology and endocrine surgery on patients from San Francisco Bay Area cities including San Francisco, Marin, San Mateo, Oakland, Walnut Creek, and beyond.
San Francisco Weight Loss, GI & Endocrine Surgery Office (MAP)
1375 Sutter Street, Ste 208, San Francisco, CA 94109
Tel. 415-923-3200 Fax. 415-923-3205
Marin Weight Loss, GI & Endocrine Surgery Office
101 Rowland Way, Ste 220, Novato, CA 94595
Tel. 415-923-3200 Fax. 415-923-3205
