Biliopancreatic Diversion
(BPD Surgery)
Are you struggling with your weight and health? You’re not alone - biliopancreatic diversion with duodenal switch (BPD/DS) is one of the most effective weight-loss surgeries in the world. BPD/DS can help you lose more weight than other procedures and improve your type 2 diabetes and other conditions. If you’re considering BPD/DS, check out our website to find out more about the advantages and benefits of this life-changing surgery.
What is BPD Surgery?
BPD is a surgical procedure that reduces the size of your stomach and bypasses a large part of your small intestine. This means that you will feel full faster and absorb fewer calories and nutrients from the food you eat. BPD also changes the way your body handles bile and pancreatic juices, which are involved in digestion and metabolism. BPD can be done as a single operation or as a two-stage procedure, depending on your health condition and preferences.
BPD is a surgery that has two main steps. The first step is called sleeve gastrectomy, which means that most of your stomach is removed and only a small tube-shaped part is left. This makes you feel full faster and eat less food. The second step is called the duodenal switch, which means that part of your small intestine is bypassed and connected to a lower part. This reduces how much calories and nutrients your body can absorb from the food you eat.
BPD is not a common surgery, but it can help people who are very obese and have serious health problems like diabetes, high blood pressure, or sleep apnea. BPD can help them lose more weight than other types of surgery, and also improve their blood sugar levels and cholesterol levels.
BPD is not for everyone, but it may be an option for some people who want to change their lives for the better. If you are interested in BPD, you should talk to the patient coordinator about the benefits and risks, and see if you are a good candidate for this surgery.
Benefits of BPD Surgery
Significant and Sustained Weight Loss:
BPD is a highly effective weight loss surgery that often results in significant and sustained weight loss, making it an attractive option for those struggling with obesity. Studies have shown that patients who undergo BPD can lose up to 70% of their excess weight within the first year after surgery and maintain most of their weight loss for up to 10 years or more. This can have a positive impact on your appearance, self-esteem, and overall well-being.
Improvement in Co-Morbidities:
BPD has been shown to improve or resolve many obesity-related co-morbidities such as type 2 diabetes, hypertension, and sleep apnea. These conditions can increase your risk of developing serious complications such as heart disease, stroke, and kidney failure. By losing weight and improving your metabolic health, you can reduce these risks and enjoy a longer and healthier life.
Reduced Hunger and Increased Satiety:
BPD involves altering the digestive tract in a way that can reduce hunger and increase feelings of fullness, helping patients to stick to healthy eating habits and avoid overeating. BPD reduces the size of the stomach, which limits the amount of food you can eat at one time. It also bypasses part of the small intestine, which reduces the absorption of calories and nutrients from food. Additionally, BPD affects the production of hormones such as ghrelin and peptide YY, which regulate appetite and satiety. As a result, patients who undergo BPD may experience less hunger and cravings and more satisfaction after eating.
Long-Term Success:
BPD has been shown to provide long-term weight loss and co-morbidity improvement, making it a potentially life-changing option for patients struggling with obesity. Unlike other weight loss methods such as dieting or medication, BPD does not rely on your willpower or compliance to achieve results. Instead, it creates permanent changes in your anatomy and physiology that can help you maintain a healthy weight for life.
Potential to Reduce Medications:
With improved co-morbidities and weight loss, patients may be able to reduce or eliminate medications they were taking prior to surgery. For example, patients who have type 2 diabetes may be able to stop using insulin or oral hypoglycemic agents after BPD, as their blood sugar levels normalize. Similarly, patients who have hypertension may be able to lower their blood pressure without medication or with lower doses. This can save you money and reduce the risk of side effects from medications.
Improved Quality of Life:
BPD can help patients improve their overall quality of life by reducing health risks associated with obesity and increasing mobility and energy levels. Patients who undergo BPD may find it easier to perform daily activities such as walking, climbing stairs, or playing with their children. They may also experience less pain and discomfort from joint problems or back issues. Moreover, they may feel more confident and happy about their appearance and their ability to participate in social events or hobbies they enjoy.
As you can see, BPD is a weight loss surgery that can offer you many benefits that can improve your physical and mental health. However, BPD is not a magic solution that can solve all your problems. It is a major surgery that involves risks and complications such as infection, bleeding, malnutrition, dumping syndrome, or bowel obstruction. It also requires a lifelong commitment to follow-up care and lifestyle changes such as taking vitamin supplements, eating a balanced diet, exercising regularly, and avoiding alcohol and smoking. Therefore, before deciding to undergo BPD, you should consult with our patient coordinator and weigh the pros and cons carefully.
Types of BPD Surgery
Standard Biliopancreatic Diversion (BPD):
This procedure involves removing a large portion of the stomach, leaving only a small pouch that can hold about a cup of food. The pouch is then connected to the last part of the small intestine, called the ileum, bypassing the duodenum and the jejunum, which are responsible for most of the digestion and absorption of food. This means that only a small amount of food can be eaten at a time, and most of the calories and nutrients are not absorbed by the body. This procedure can result in significant weight loss, but also in severe malnutrition, especially of protein, calcium, iron, and vitamins. Therefore, people who undergo this procedure need to take lifelong supplements and follow a strict diet.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS):
This is a modified version of the standard BPD procedure. In this procedure, a smaller portion of the stomach is removed, leaving a tube-shaped stomach that can hold about 3 to 5 ounces of food. The stomach is then connected to a part of the small intestine called the duodenum, which is where bile and pancreatic juices help break down food. The duodenum is then connected to the ileum, bypassing most of the jejunum. This means that more food can be eaten at a time, and some digestion and absorption still occur in the duodenum, but most of the calories and nutrients are still not absorbed by the body. This procedure can also result in significant weight loss, but less malnutrition than the standard BPD procedure. However, people who undergo this procedure still need to take lifelong supplements and follow a strict diet.
Single Anastomosis Duodeno-Ileal Switch (SADI-S):
This is a newer variation of the BPD/DS procedure. This procedure involves making a single connection between the stomach and the ileum, bypassing most of the small intestine. This means that less food can be eaten at a time, and most of the calories and nutrients are not absorbed by the body. This procedure can also result in significant weight loss, but less malnutrition than the standard BPD procedure. However, people who undergo this procedure still need to take lifelong supplements and follow a strict diet.
Scopinaro Procedure:
This procedure involves removing a large portion of the stomach, leaving a small pouch that can hold about 2 ounces of food. The pouch is then connected to a part of the small intestine called the jejunum, bypassing most of the duodenum and ileum. This means that less food can be eaten at a time, and most of the calories and nutrients are not absorbed by the body. This procedure can also result in significant weight loss, but more malnutrition than the BPD/DS procedure. Therefore, people who undergo this procedure need to take lifelong supplements and follow a strict diet.
Mini Biliopancreatic Diversion (BPD):
This is a less commonly used variation of the BPD procedure, which involves removing less of the stomach and bypassing a smaller portion of the small intestine. This means that more food can be eaten at a time, and more calories and nutrients are absorbed by the body. This procedure can result in moderate weight loss, but less malnutrition than other BPD procedures. However, people who undergo this procedure still need to take lifelong supplements and follow a strict diet.
As you can see, there are many options for biliopancreatic diversion surgery, each with its own advantages and disadvantages. If you are considering this type of surgery, you should consult with patient coordinator.
The BPD Surgery Procedure
Before the Surgery
Before you undergo Biliopancreatic Diversion surgery, you will need to complete some important steps to ensure you are a good candidate and ready for the operation.
These steps include:
- Initial Consultation: The patient will meet with a bariatric surgeon for a consultation to discuss their medical history, weight loss goals, and suitability for Biliopancreatic Diversion surgery. This is a great opportunity to ask any questions you may have about the procedure, its benefits and risks, and the expected outcomes.
- Medical Tests: The surgeon may order various tests to evaluate the patient's health, such as blood tests, imaging tests, and electrocardiogram (ECG). These tests will help the surgeon determine if the patient has any medical conditions that may affect the surgery or require special care.
- Diet and Exercise: The patient will be advised to follow a strict diet and exercise regimen in preparation for the surgery, which may include a liquid diet a few days before the procedure. This will help the patient lose some excess weight, reduce the size of the liver, and lower the risk of complications.
During the Surgery
Biliopancreatic Diversion surgery is a complex and invasive procedure that involves altering the anatomy of the stomach and small intestine.
The surgery typically takes about 3 to 5 hours to complete and consists of the following steps:
- Anesthesia: The patient will be given general anesthesia to ensure they are asleep and pain-free during the procedure.
- Incision: The surgeon will make a large incision in the abdomen to access the stomach and small intestine.
- Diverting the Bile: The surgeon will divide the small intestine and reroute the bile duct from the liver to the lower part of the small intestine, bypassing most of the stomach and upper part of the small intestine. This will reduce the amount of calories and nutrients absorbed by the body from food.
- Sleeve Gastrectomy: The surgeon will remove a large portion of the stomach, leaving behind a banana-shaped pouch that connects directly to the lower intestine. This will limit the amount of food that can be eaten at one time and create a feeling of fullness faster.
- Reconnecting the Intestine: The surgeon will then connect the lower part of the small intestine to the remaining stomach pouch, allowing food to pass through and mix with digestive juices. This will enable digestion and absorption of some essential nutrients.
After the Surgery
After Biliopancreatic Diversion surgery, you will need to follow a strict post-operative care plan to ensure a smooth recovery and optimal results.
This plan includes:
- Hospital Stay: The patient will need to stay in the hospital for several days to recover from the surgery, and may be given pain medication to manage any discomfort. The patient will also receive intravenous fluids and nutrition until they are able to tolerate oral intake.
- Diet and Nutrition: The patient will be given specific dietary instructions to follow, including eating small, frequent meals and avoiding high-fat, high-sugar foods. The patient will also need to take vitamin and mineral supplements for life to prevent deficiencies caused by malabsorption.
- Follow-Up Care: The patient will need to attend regular follow-up appointments with their surgeon to monitor their weight loss progress and address any concerns or complications. The patient may also benefit from joining a support group or counseling program to cope with any emotional or psychological changes.
Biliopancreatic Diversion surgery is a major decision that requires careful consideration and preparation. By knowing what to expect before, during, and after the procedure, you can make an informed choice and achieve your weight loss goals. I hope this blog post has been helpful and informative for you. If you have any questions or comments, please feel free to book a free consultation with our patient coordinator.
Recovery from BPD Surgery
1 week:
Pain and discomfort: Patients may experience some pain and discomfort for the first few days after the surgery. Pain medication may be prescribed to manage this.
Hospital stay: Patients typically remain in the hospital for 3-4 days after the surgery.
Limited activity: Patients are advised to rest and avoid any strenuous activity for the first week.
2 weeks:
Gradual increase in activity: Patients can slowly begin to increase their activity levels, but should still avoid any strenuous activity or heavy lifting.
Follow-up appointments: Patients will have follow-up appointments with their surgeons to monitor their progress and ensure there are no complications.
3 weeks:
Return to work: Many patients can return to work during the third week, as long as their job does not involve heavy lifting or strenuous activity.
Introduction of solid foods: Patients will begin to introduce solid foods back into their diet, starting with soft, easily digestible foods.
4 weeks:
Increased activity: Patients can gradually begin to increase their activity levels, but should still avoid any strenuous activity or heavy lifting.
Continued follow-up appointments: Patients will continue to have follow-up appointments with their surgeon to monitor their progress and ensure there are no complications.
3 months:
Weight loss: Patients will typically see significant weight loss during the first three months after surgery.
Continued diet and exercise: Patients should continue to follow a healthy diet and exercise regimen to ensure successful weight loss and maintain their overall health.
6 months:
Continued weight loss: Patients will continue to see weight loss during the first six months after surgery.
Possible side effects: Some patients may experience side effects such as nausea, vomiting, or diarrhea, which should be reported to their surgeon.
1 year:
Stable weight loss: Patients should have reached a stable weight by one year after surgery.
Continued follow-up appointments: Patients will continue to have follow-up appointments with their surgeon to monitor their progress and ensure there are no complications.
Risks and Complications
One of the main risks of BPD is malabsorption, which means that your body does not absorb enough nutrients from the food you eat. This can lead to deficiencies of vitamins, minerals, protein, and fat-soluble vitamins (A, D, E, and K). Some of the symptoms of malabsorption include anemia, osteoporosis, kidney stones, diarrhea, nausea, and weakness. To prevent malabsorption, you will need to take supplements for the rest of your life and follow a strict diet that is high in protein and low in fat and sugar.
Another risk of BPD is dumping syndrome, which occurs when food moves too quickly from the stomach to the small intestine. This can cause unpleasant reactions such as shakiness, faintness, sweating, rapid heartbeat, cramps, and vomiting. Dumping syndrome can be avoided by eating small meals throughout the day and avoiding foods that are high in sugar or fat.
BPD also carries some risks that are common to any abdominal surgery, such as bleeding, infection, leakage, blood clots, and breathing problems. These risks can be reduced by choosing a qualified surgeon who has experience with BPD, following the pre-and post-operative instructions carefully, and reporting any signs of complications to your doctor as soon as possible.
BPD is a complex and irreversible surgery that requires lifelong commitment and lifestyle changes. It is not a quick fix or a magic solution for obesity. It is only recommended for people who have a body mass index (BMI) of 50 or higher or a BMI of 40 or higher with serious health problems such as type 2 diabetes or sleep apnea.
If you are considering BPD as an option for weight loss, you should consult with our patient coordinator and a bariatric team to weigh the benefits and risks carefully.
