Biliopancreatic Diversion with Duodenal Switch (BPD-DS)

Biliopancreatic Diversion with Duodenal Switch (BPD-DS) is a type of gastric bypass surgery for patients with a BMI of 40 or more.

BPD-DS is a two part process surgery with a partial gastrectomy procedure followed by the BPD-DS procedure. A partial gastrectomy removes around just half of the stomach compared to the 85 per cent of stomach which is removed during the Vertical Sleeve gastrectomy. After the partial gastrectomy, the patient is given a few weeks to lose some weight before having the second part of the surgery.  

The second procedure divides the small intestine into two parts. One part, the alimentary limb, is connected to the bottom of your stomach. The rest of your small intestine, the biliopancreatic limb, is attached to the bile duct. Food travels down the alimentary limb into the colon, without being absorbed in the biliopancreatic limb. Digestive juices flow freely from your biliopancreatic limb to your alimentary limb. This procedure causes food to be digested but not absorbed by the body.   

Advantages of BPD-DS 

  • Ranks among the highest rates of weight loss in the first year. 
  • Good long-term weight loss and maintenance. 
  • Good choice for high-BMI patients. 

Disadvantages of BPD-DS

  • Likelihood of nutritional deficiencies, including protein and vitamins and minerals. 
  • Patients are likely to experience diarrhoea and dumping syndrome if the postoperative diet is not being followed. 
  • The procedure is irreversible, offering fewer options for revisional surgery.  

Complications and risks associated with BPD-DS 

  • Death (1 per cent risk related to surgery)
  • Diarrhoea
  • Flatulence 
  • Nutrient deficiencies 
  • Vomiting after surgery

Weight Loss & BPD-DS 

BPD-DS reduces the size of the stomach by 50 per cent. The size of the stomach pouch after BPD-DS weighs only four to five ounces, which is a severe restriction to the capacity of the stomach. The result is feeling fuller for longer and absorbing fewer nutrients. Less nutrients are absorped as food bypasses part of the small intestine and the digestive juices have been rerouted. Food is still broken down in the gastrointestinal tract but is not completely absorbed by the body. 

Please seek and follow the specific guidelines from your bariatric team. Guidelines vary for individual patient needs and surgeries.​