Biliopancreatic diversion (with or without duodenal switch)

This is one of the most technically demanding of the various obesity procedures. It can be performed as either a biliopancreatic diversion on its own or with a duodenal switch. They are both performed although the version with the duodenal switch is now more commonly undertaken.

It is often known by the acronym BPD/DS or ‘a switch’ for short. It is also classed as a restrictive/malabsorptive procedure.

The BPD version, without the duodenal switch is also known as the ‘Scopinaro’ procedure. This is named after the surgeon who invented the procedure. There is also another version called the ‘Bandinaro’: this procedure combines the restrictive element of the gastric band with the rerouting of the small intestine – the malabsorptive aspect.

In spite of its complexity it is still a very good choice of procedure for those patients with chronic weight issues.

What is a biliopancreatic diversion?

It is very similar to the traditional Roux-en-Y gastric bypass. This means that it restricts food consumption and absorption as well. However, the difference between this and the bypass is that malabsorption is greater. This means that there is a higher risk of malnutrition and other similar deficiencies.

It is less popular than other obesity procedures but is still a option for those patients who have a very high BMI.

The difference between this and the gastric bypass is that a larger percentage of the stomach is left. And, a small part of the small intestine called the duodenum is left. The duodenum is the top part of the small intestine.

Another important aspect is that of the controlled release of food: when food contents are about to leave the stomach they do so via a small opening called a pyloric valve. This controls the release of those contents. This is not affected with a PBD/DS whereas it is affected from a gastric bypass.

Biliopancreatic diversions guide sections

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