Biliopancreatic diversion with duodenal switch is a restrictive and powerful metabolic procedure. The amount of food a patient consumes is reduced, and anatomy alterations results in metabolic changes. This leads to a decrease in hunger and an increase in metabolism.
1. The stomach is divided creating a narrow tube with a stapling device, and the excess stomach is removed (sleeve gastrectomy). This limits the amount of food that can be eaten (restrictive), and with combined hormone changes patients feel full and satisfied from small meals.
2. The small bowel is divided about 250 cm from the colon. One end is brought up and attached to the duodenum, just beyond the stomach sleeve. The other end of the small intestine is reconnected to the intestinal tract 100 cm from the colon and is a route for digestive enzymes. This creates food being routed past the majority of the small intestine, and results in metabolic changes that lead to beneficial hormone stabilization and the resolution of metabolic syndromes, including type II diabetes, high blood pressure, and high cholesterol.
The majority of BPD-DS procedures performed today use a minimally invasive laparoscopic technique, with 7–8 small abdominal incisions. Most patients are discharged the day after surgery, but some stay two nights depending on their recovery.