Michael Schweitzer, M.D., F.A.C.S
The Johns Hopkins Obesity Surgery Center The Johns Hopkins University School of Medicine and Health Systems
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Information Criteria Consultation Forms You Will Need!! Resume Insurance The Diet After Surgery Directions Video Links Home Page	Laparoscopic Duodenal Switch with Biliopancreatic Diversion Procedure: 1) The left lateral side of the stomach is removed. 2) A Roux-en-Y is constructed. 3) The Roux limb is connected to the duodenum just past the stomach 4) The Roux limb carries the food from stomach down to the next connection (anastomosis). 5) The lower intestinal connection is where the food (Roux limb) mixes with the biliopancreatic limb (carries the bile and pancreatic fluid that helps digest fats and proteins). 6) There is approximately 100 cm where the food, bile, and pancreatic fluid mix and digest before it empties into the colon. In Summary: The duodenal switch with biliopancreatic diversion has a larger stomach reservoir (less restriction) and a greater amount of malabsorption when compared to a gastric bypass which has a smaller stomach pouch (more restriction) and less malabsorption. Advantages Well documented excess weight loss in published series 60 to 80% (average) over 1.5 to 2 years. May keep weight off better than gastric bypass *(not proven since there is no randomize study to compare the two operations) 70 to 80% diabetes resolved in many published series. Most do not get dumping syndrome. Disadvantages Permanent removal of lateral stomach. Iron and calcium malabsorption Vitamin deficiency of A,D,E, and K are possible. Protein malabsorption Excessive diarrhea and flatus 5-10% need to have a revision to lengthen the common channel Risks* 1)Leak of stomach/intestinal fluid from the staple line or suture line 2)Stricture 3)Ulcer 4)Bowel obstruction 5)Bleeding 6)Blood Clots 7)Heart attack and stroke (if at risk) 8)Malabsorption, diarrhea, nutritional deficiencies 9)Death Please read Complication list (click) *These are some of the risks, please discuss at your consultation and ask questions. In most cases the risks are low but this is major surgery. Corrective surgery(s) may be necessary if complications arise.