Biliopancreatic Diversion

Biliopancreatic diversion with a duodenal switch (BPD/DS), also called the “duodenal switch” or the “switch” for short, is a surgical weight loss procedure utilizing both restrictive and malabsorptive methods to achieve long term weight loss. BPD/DS improves upon the standard biliopancreatic diversion which was originally developed by Dr. Scopinaro in Italy and later modified by surgeons in the US and Canada. This complex procedure generates weight loss by restricting the amount of food that can be eaten, which then limits the amount of food the body will absorb.

General Procedure

The BPD/DS procedure involves the removal of approximately 1/2 to 2/3 of the stomach. This procedure improves on other gastric bypass procedures such as biliopancreatic diversion (BPD) and Roux-en-Y (RNY) by leaving intact more of the stomach and the entire pyloric valve, which regulates the flow of stomach contents into the small intestine. By dividing the small intestine into two parts the alimentary and biliopancreatic limbs are created. One end of the alimentary limb is connected to the now smaller stomach, while the other end remains attached to the colon. Food leaving the stomach travels through the alimentary limb, thereby avoiding the majority of the digestion that takes place in the small intestine. The biliopancreatic limb is connected to the bile duct and joins the alimentary limb to form the common channel which ends at the colon. Digestive juices then flow from the stomach and pancreas through the biliopancreatic limb and mix with food at the start of the common channel.

Compared to other gastric bypass procedures, BPD/DS is one of the most effective at creating long-term weight loss. It provides the most malabsorption of all weight loss surgeries performed today. For this reason it has been seen as controversial because it carries with it a risk of malnutrition. It’s important that a patient is monitored closely by a physician on a regular basis to ensure the proper absorption of vitamins and minerals.

Advantages of biliopancreatic diversion with a duodenal switch (BPD/DS):

Disadvantages/risks of biliopancreatic diversion with a duodenal switch (BPD/DS):