Duodenal Switch

The duodenal switch procedure, or biliopancreatic diversion with duodenal switch (BPD-DS), reduces the amount of calories absorbed by the body by permanently altering the normal digestive process. Like other metabolic surgeries, it helps to establish a lower, healthier body fat set point by changing the signals between the stomach, brain, and liver. While the procedure is considered a malabsorptive procedure, it also limits the amount of food that can be eaten by reducing the size of the stomach.

What Happens During a Duodenal Switch Procedure?

During the procedure, the outer margin of the stomach is removed, leaving a small, tubular stomach. Then, the first section of the small intestine is divided into two sections. One section, called the alimentary limb, is connected to the stomach pouch. The food you eat travels through this segment. The second section, called the biliopancreatic limb, keeps digestive juices from the gall bladder and pancreas separate until the two sections join at the common channel. The result of this rerouting is that significantly fewer calories are absorbed from the food you eat.

SADI-S - Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy

This is a newer variant of duodenal switch surgery. The key benefit of SADI-S is that one intestinal bypass is made, rather than two, resulting in less time in surgery and reduced risk of intestinal leakage. About 80% of the stomach is removed, leaving the remaining portion of the stomach shaped like a tube or sleeve. Just below the opening of the stomach (this is called the pylorus) is the duodenum. This is the first part of the small intestine. Your surgeon will divide the small intestine and shape it into a loop that is connected to the stomach. This is the only intestinal connection in this procedure.

SADI-S removes less of the intestine than other types of bariatric surgery, increasing the amount of nutrients your body will be able to absorb. Because only one new intestinal connection is made in SADI-S, there is less risk of contents leaking from the intestine into the body cavity. The single connection also has the advantage of preventing the possibility of future bowel obstruction, also known as an internal hernia.

Duodenal Switch Risks

While the procedure helps many lose weight, it’s not the right choice for everyone. In addition to the general risks of surgery, the following risks are associated with the duodenal switch procedure:

• It can take time for your intestines to adapt, so bowel movements can be very liquid and frequent after the procedure. This condition may lessen over time, but may be permanent.
• Abdominal bloating and foul smelling stool or gas may occur.
• Because this is a malabsorption procedure, vitamin deficiencies may occur. As a result, lifelong vitamin supplementation is required. If eating and vitamin supplement guidelines are not rigorously followed, at least 25% of patients will develop problems that require treatment. In addition, close lifelong monitoring for protein malnutrition, anemia, and bone disease is recommended.
• Changes to the intestinal structure increase the risk of gallstone formation and the need for removal of the gallbladder.
• Rerouting of bile, pancreatic, and other digestive juices beyond the stomach can cause intestinal irritation and ulcers.

Get Started on Your Weight Loss Journey

Making the decision to have weight loss surgery can feel extremely overwhelming. The caring and compassionate team at SSM Health Weight Management Services will help you consider all of your options - both surgical and nonsurgical - so you can feel confident in your choice. Make an appointment today so you can get started on your path to better health.