The BPD is the old Scopinaro procedure:  http://www.duodenalswitch.com/procedure/1998bpd/1998bpd.html

Nomenclature issues notwithstanding, the BPD/DS is NOT a BPD.

In a BPD, the bottom of the stomach is removed, giving you a permanent pouch. BAD THING. Most of your duodenum is gone forever. BAD THING. I will allow medical folks to explain this in more detail.

In a subtotal vertical gastrectomy with duodenal switch. you retain your pylorus. No pouch. You retain all of your small intestine, making the intestinal part of the procedure COMPLETELY REVERSIBLE.

The BPD is rarely done any more except by a few surgeon in Australia and a few other surgeons worldwide who manage to get one over on patients who are not sufficiently educated in their options to know better. Don't be one of those. Come on over to the DS board and learn about the BEST option, the REAL duodenal switch.

Also, start your research reading at www.dsfacts.com .

Elizabeth,

What about if you are of normal weight, and just need the bottom, intestial portion for insulin/diabetes.  Would this be the surgery to have?  I only ask because I have a co-worker who has insulin diabetes, and I e-mailed Dr. K and got not a good answer.  My co-worker was diagnosed 5 years ago.  But is in good health, and not overweight/obese.


Here is an e-mail to Dr. K about this:
I have a co-worker, with no obesity problems, but he has diabetes (Insulin Resistant) what is the name of that procedure, where Dr. K does not touch the stomach, but just does the intestional portion of the surgery?  I have looked and looked for it, but since I do not have the actual name, all I have come up with is the procedure where the stomach is also operated on as well.  Any information and/or research, and even internet links that you may have and can pass along to me for him would be GREAT as well!!!!!!

And here is his reply back to me:
(Nice to have a reply from the doc himself, I find myself fortunate for that)
Hello, It is the duodenal switch without the sleeve gastrectomy part of the operation.  Thank you.
Ara

-Jamie in Alaska 

She needs the duodenal switch without a VSG. There is such a thing as a biliopancreatic diversion WITHOUT duodenal switch. Dr. K.'s answer is entirely accurate.

OK, thanks for the clairification.  Now I understand and I am not so confused.  (That Ah-Ha moment)



THANKS, Elizabeth!!!!!
-Jamie

I haven't been there in years, but Dr. Baltasar's website used to have info about "just" the switch for diabetes. I *think* the website is www.bodybybaltasar.com.

 I've heard of it being done in Europe on normal weight people, just for t2diabetes. Maybe target European studies? I'll look and link if I find something, but it won't be today - have to go do the fathers day thing right now.

Hello, everyone!  After years of lurking, I feel like the time is right to start participating in these conversations/encouragements/affirmations.

I guess you could sort of call this a BUMP after years of inactivity... I am confused as to the reason why so many people on the forum... heck, just on this thread alone, are acting as if the BPD alone is such a barbaric procedure.  Believe it or not, it is indicated at times... and from the way the guru himself, Dr. Keshishian explains it, the BPD is "the duodenal switch with out the sleeve gastrectomy part of the operation."

MY STORY: First of all, let me just say that I am a medical professional that has done extensive research on all of the available revision procedures, and felt like the duodenal switch would be the best option for me, both given my health history, relatively young age, and active lifestyle. The success rates, both in terms of weight loss, and its permanence, have been better for duodenal switch patients... not to mention their improved overall quality of life.   I have had both RNY gastric bypass surgery in 2000, and lap band placement done in 2008. I stand 5'2", and at my heaviest in 2000, I weighed as much as 250 lbs. Afrer having RNY gastric bypass surgery, my lowest weight was 145 lbs, in 2005.   My concern is that I am have been actively exercising with a trainer twice a week, and I limit my carbohydrate intake; yet, I have managed to creep up back up over 200 lbs again. I have also developed an increase in my blood pressure, along with the weight gain.   It is for these reasons, and a few others, that I am seeking a revision to the duodenal switch surgery. I am aware that the DS is a complicated procedure, especially after having had other abdominal surgeries in the past. I have been communicating with a number of surgeons regarding my revision surgery, MANY of them being the forum favorite "vetted experts" at handling complex cases, like mine.   All of the physicians that I contacted regarding revising my Band over Bypass to a DS had numerous issues with what could result in terms of complications in performing a DS on me, mainly much higher probability of leakage.  I think it best to be mindful of the experts that I contacted when deciding what is right for myself, both in terms of practicality, probability, and finances.  I raise the finance issue up, because as a "lightweight with great potential to become a heavyweight", insurance does not cover this sort of surgery for me, which makes me a self-pay patient. This, however, did not stop me from doing my due diligence in fully researching revision surgeries and surgeons, both in and out of the United States.   I contacted a very well regarded/experienced/published/proven surgeon in Brazil, and explained my situation to him, hoping that he would be able to help me.  Given the risk/benefit ratio of doing yet ANOTHER surgery to my already modified stomach anatomy, he offered the BPD as a valid alternative that presents the possibility of an identical outcome to a DS revision (remember that this would be FAR from a virgin DS) without nearly as many risks of complications.  I was really excited about the possibility of this, until I got on this board, then BAM!  All I've seen is extremely negative comments regarding this procedure, and usually by the same people that are are so "pro-DS"... when, as I said from the beginning of this novel, Dr. Keshishian himself even described this as he did.  I would love to hear more from people about the reason why BPD has such a bad rap... please!       I am in the Chicago area, so needless to say, it is COLD here... I would like to look forward to having a summer where I don't feel so blimpy, for lack of better words.

 

The intestinal portion of the duodenal switch procedure ("just the switch") to treat type 2 diabetes is done in Spain by Baltasar, by Ungson in MX, and I believe by Marchesini in Brazil. 

Sorry, just curious, but would that be what is called the duodenal-jejunal bypass?

Perhaps - but you can exclude the distal duodenum and jejunum in different ways, so you can't say exactly WHAT duodenal-jejunal bypass means without reference to how it is constructed.  For example, there is a group in Spain (and now, apparently Dr. Roslin in NYC), doing a "single anastomosis DJB," with a short (200 cm) alimentary tract/common channel (it is all common channel) and the DJ piece hanging upstream - but he calls it a DJB too.  A "switch" has a longer alimentary tract (250 cm plus) and a shorter (~100 cm) common channel, with a RNY-type anastomosis connecting the biliopancreatic limb.  But technically, you could call that construction a DJB too.