A Guide to Biliopancreatic Diversion
Biliopancreatic diversion may be a suitable option for weight loss surgery for those who are diagnosed as clinically obese.
In this type of surgery, the normal process of digestion is changed by reducing the size of the stomach and rerouting food to pass by a section of the small intestine, thus limiting the calorie absorption.
Thus, the patient will feel full faster than before the surgery, which in turn cuts back the amount of food (and calories) consumed. Weight loss is achieved when the body absorbs fewer calories.
There are two types of this surgery: a biliopancreatic diversion and a biliopancreatic diversion with duodenal switch.
- In a biliopancreatic diversion, part of the stomach is surgically removed, and the remaining portion is connected to the lower portion of the small intestine.
- In a biliopancreatic diversion with duodenal switch, a portion of the stomach is removed, but it is smaller than in the other type of surgery. And the remaining stomach remains attached to the duodenum (the upper part of the small intestine). The duodenum is connected to the lower part of the small intestine.
There are two ways to approach these procedures: the open procedure, in which the surgeon makes a large incision in the abdomen; or the laparoscopic approach, which calls for the surgeon to make a small incision, through which small medical instruments and a camera can be inserted into the body to guide the surgical process for the surgeon.
Post Biliopancreatic Diversion SurgeryAfter biliopancreatic surgery, the majority of patients can resume normal activities within 3 to 5 weeks. Patients will be required to have a follow-up visit with their surgeon 3 weeks after the procedure, and then every 3 months for the next year. After the 1-year mark, a patient will only need to schedule appointments once annually.
Risks of Biliopancreatic Diversion SurgeryOne of the risks of biliopancreatic diversion is that it may cause dumping syndrome. This occurs when food moves too quickly through the stomach and intestines, producing nausea, diarrhea, vomiting, sweating, weakness, faintness soon after eating. Patients who veer from the recommended diet may aggravate these symptoms by eating highly refined, high-calorie foods like candy and other sweet foods. Some patients report feeling so weak they need to lie down until the symptoms fade. Dumping syndrome occurs less often in a biliopancreatic diversion with duodenal switch.
Candidate for Biliopancreatic DiversionTo be considered eligible for this procedure, a patient must be able to demonstrate that he or she had tried to lose weight with little or no success. Also, many doctors will only perform the surgery on patients who are not at high risk for developing other serious health problems related to their weight.
There are different guidelines available, but in general, a person is deemed eligible for weight loss surgery when his or her body mass index is 40 or higher, or if the patient has a weight-related, life-threatening or disabling condition.
Other factors may be taken into consideration, such as, the patient:
- Has been obese for at least 5 years.
- Has no history of alcohol abuse.
- Does not have depression or another major psychiatric disorder that has gone untreated.
- Is between ages 18 and 65.
Success Rate of Biliopancreatic DiversionThe high success rates for biliopancreatic diversion surgeries prove the procedure is effective. Most people lose 75% to 80% of their excess weight and are able to maintain their new weight.
Risks of Biliopancreatic DiversionAs with any surgical procedure, weight loss surgery also carries certain risks and complications. Biliopancreatic diversion surgeries run the risk of infection, leakage from the stomach into the abdominal cavity or where the intestine is connected and which can result in a serious infection and blood clots. It is estimated that about one-third of all people who have weight loss surgery develop nutrition-related ailments such as anemia or osteoporosis.
Because biliopancreatic surgeries are so complex, they require a very experienced bariatric surgeon at the helm. It is necessary for the patient to do the necessary research to find the surgeon best qualified to deal with their individual circumstances.