Biliopancreatic Diversion

What is Biliopancreatic Diversion surgery?

Biliopancreatic Diversion Surgery is where a part of the stomach is removed and an intestinal bypass procedure is performed. There are two different surgical methods, which both result in a reduction of the remaining stomachs capacity and the bypass of around 90% of the small intestine. The reduction in the stomachs capacity reduces a patient's ability to over eat and the bypass surgery results in additional weight loss from any consumed food, in that it causes deliberate malabsorbtion of nutrients and calories. The two different surgical methods are known as Biliopancreatic Diversion and Biliopancreatic Diversion with Duodenal Switch.

Who will benefit from Biliopancreatic Diversion surgery?

Candidates who are guided towards this type of procedure are typically those with the greatest weight loss challenge; in that they are morbidly obese, but do not trust themselves with the task of eating significantly smaller quantities for the rest of their life. However, this surgery would only be suitable for a patient who was completely committed to taking nutritional supplements and to eating additional protein in their diet on a daily basis, as this will be key to combating the malabsorbtion caused by the bypass procedure.

In order to benefit and qualify for BIliopancreatic Diversion Surgery patients must meet the following criteria:

• Have significant experience and history of diet failures
• Demonstrate a genuine desire to overcome their obesity problems
• Make a full commitment to finally getting their weight under control
• Fully understand both the benefits and the risks of weight loss surgery
• Have a Body Mass Index (BMI) of 35 to 39 with other obesity related health problems
• Or, have a Body Mass Index (BMI) of 40 or above

How is a Biliopancreatic Diversion procedure carried out?

There are two methods of performing Biliopancreatic Diversion surgery:
 
1. Biliopancreatic Diversion: in this procedure a portion of the stomach is removed. The remaining portion of the stomach is connected to the lower portion of the small intestine.

2. Biliopancreatic Diversion With Duodenal Switch: a smaller portion of the stomach is removed, but 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.

These procedures can be done by making a large incision in the abdomen (an open procedure) or endoscopically, by making a number of 'keyhole' incisions and using small instruments and a camera to guide the surgery. Both methods of surgery are usually carried out under a General Anaesthetic (you will be asleep throughout the procedure) and will involve a 2 - 7 day stay in hospital, dependent on the complexity of each case and the method of surgery chosen.

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as mobile as possible to avoid complications such as Deep Vein Thrombosis. Following a progressive improvement of mobility and pain control patients are normally discharged home 2-4 days after surgery if the procedure was performed endoscopically or after 5-7 days if an open procedure was performed.

In the early days following discharge patients are strongly advised to stay gently mobile at home, but to avoid any level of activity that would put undue strain on the new bypass or related surgical wounds.

Patients will be advised to take a specific amount of recovery time away from work, dependent on the type of job they perform, but it is usual to take around two weeks off and to refrain from any strenuous exercise for at least 8 weeks following surgery.

Patients are discharged with strict meal planning advice, but in the first weeks after surgery the majority of patients will be unable to tolerate anything other than a very light and soft/liquid diet. Gradually a patient's ability to tolerate most types of food will improve, although the volume of food they are able to consume in one intake will be substantially and permanently reduced.

Are there any risks associated with Biliopancreatic Diversion surgery?

All surgery involves an element of risk from developing complications. Risks such as bleeding, delayed healing, scaring, infection, nausea and vomiting, bowel perforation or leakage will all be discussed openly at consultation, as well as our scrupulous efforts to manage and minimise these risks to their lowest possible potential.

Smoking may adversely affect wound healing and heavy smokers may be precluded from having this type of surgery as a result.

A Biliopancreatic Diversion may cause dumping syndrome, which occurs when food moves too quickly through the stomach and intestines. This side effect causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating. These symptoms are made worse by eating highly refined, high-calorie foods (like sweets). In some cases patients may become so weak that they have to lie down until their symptoms pass. Dumping syndrome does not occur in a Biliopancreatic Diversion with Duodenal Switch.

Although Biliopancreatic Diversion Surgery is regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking this type of specialist weight loss surgery.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation to discuss your understanding and expectations in relation to these risks with an Expert Consultant Gastro-Intestinal Surgeon with significant Weight Loss Surgery experience cannot be over emphasised.

How do I find out if I am a suitable candidate for Biliopancreatic Diversion surgery?

Surgical Advisor will be delighted to help you find a leading expert surgeon in Weight Loss Surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Gastro-Intestinal Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating complex Weight Loss Surgery and because of their Gastric Bypass Surgery expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an Expert Gastro-intestinal Surgeon in Gastric Bypass Surgery: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com