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Biliopancreatic Diversion (BD)

Biliopancreatic Diversion is a type of bariatric surgery that restricts the amount of food allowed into the stomach. More specifically, the stomach is made smaller than it is, promoting weightloss for people who suffer from morbid obesity. Malabsorptive operations, such as biliopancreatic diversion (BPD),restrict both food intake and the amount of calories and nutrients the body absorbs.

In a BPD procedure, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the colon. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed.

This procedure has two components. A limited gastrectomy results in reduction of oral intake, inducing weight loss, especially during the first postoperative year. The second component of the operation is a construction of a long limb Roux-en-Y with a short common channel of 50 cm length. This creates a significant malabsorptive component which acts to maintain weight loss long term.

Recently published long term results of this operation report 72% excess body weight loss maintained for 18 years. In 1993, a group of Canadian doctors published the first results of a modification of the BPD procedure known as the biliopancreatic diversion with duodenal switch.

The BPD/DS preserves the pyloric valve that connects the stomach to the beginning portion of the small intestine. In addition, physicians increase the length of the small intestine left intact. As a result of these adjustments, this variant reportedly carries fewer complications but with comparable or greater weight loss.

The BPD is unique because it is the only current procedure that allows you to eat normal quantities of food and still achieve excellent weight loss. But there’s a catch. The procedure still carries some malabsorptive complications, including loose stools, malodorous gas, and serious deficiencies in protein and minerals such as calcium. BPD patients must take vitamin supplements for the rest of their lives to avoid malnutrition and bone demineralization.

Surgery for obesity usually involves a four to six day hospital stay (two to three days for a laparoscopic approach). Most people can return to their normal activities within three to five weeks. After biliopancreatic surgery, you generally see your surgeon three weeks after surgery and then every three months for one year. After one year, see your surgeon annually.