Question:
Has anyone heard of or had experience with the wls called biliopancreatic diversion ?

This surgery is a version of the rny but is called long limb or biliopancreatic diversion. There are supposedly only 9 doctors in the U.S. that performs this surgery, Dr. Maguire in Kettering, Ohio being one of them. It is different from the rny because a larger stomach pouch is created allowing the person to eat more normal amounts of food.    — Lisa B. (posted on November 19, 1998)


January 25, 1999
I am having the Bilopancreatic Diversion with Duodenal Switch as discribed ( perfected by ) Dr. P. Marceau of Laval Quebec Canada. This surgery is written up in the World Journal of Surgery 1998 September. This surgery is a REVISION to my failed VBG from '91. It is very invasive, non reversible, and the only choice left to me according to my surgeon here in Canada. check it out<<<http://www.jetlink.net/ref-1.htm
   — Kaushia

March 14, 1999
There is now a support group for the Bilopancreatic Diversion plus Duodenal switch...Also known as Distal Gastric bypass with Duodenal Switch in the U.S.A. Support group site is < [email protected] >
   — Kaushia

March 14, 1999
There is now a support group for this type of surgery called < [email protected] > Look in it's archives for a full discription of the surgery. Surgery is called"Bilo Pancreatic Diversion with Duodenal Switch and/or Distal Gastric Bypass with Duodenal Switch".
   — Kaushia

March 18, 1999
Lisa, I had this surgery with Dr. Gary Furman in Los Angeles on January 9, 1997. I have lost 190lbs. I can eat like a normal human being with only restrictions on the fat intake. I think this is the best of all wls surgeries for volume eaters and high fat eaters. It is the most extensive with the most possible nutritional def. if you do not follow doctors orders for vitamins and iron post op. But it is the best thing that has ever happened to me and I would do it again tomorrow. Allison
   — Allison Mupas

May 10, 1999
Yes. My Dr, Donald McConnall, is one of those 9, and one of only 2 on the West coast that do this surgery. My best friend just came out from the surgery, and is recovering WONDERFULLY. Although she cannot eat more than about 1/2 cup of food per sitting, she is basically "normal" (whatever that is <G>). This is the same surgery that I am trying for. Biliopancreatic bypass surgury with a duodenal switch involves taking about 1/2 of the stomach, and about 60% of the intestines, measuring about 5cm down from the duodenum and about 100cm up from the top of the colon. The Dr. then attaches the two ends together permanantly. ICU is usually about 24 hours, and additional hospital stay is about 4 days barring complications. As soon as you pass gas, you are able to switch to "pureed" soft foods and liquids other than water, and depending on the Dr, the scar is actually pretty minimal and heals fine if you follow the dr's suggestions for care and treatment. You are then home for about 2 1/2 weeks after that, and can return to light duties at work for another 2 or 3 weeks until you are up to working full time again. While most ins companies don't cover obesity surgery that includes staples, they CAN make an exception for this surgery due to the fact that there are NO gastric staples or sutures. It's actually totally removed.
   — Molly S.

May 15, 1999
I don't know how many doctors do this but I am having it done on June 1st. It seems to be very very successful and my doctor highly recommends it for the "heavier" person. with the intestines diverted it is very difficult to gain weight back as you will get sever pains and diahrea if you eat too many fats and such. Basically fats do not have time to digest and go right through you and yes, you have to make sure you take your supplements too.
   — BARBARA R.

March 7, 2000
I had this surgery have pancreatitis now is this common?
   — louise M.

March 8, 2000
So many of the answers here are patently incorrect. I suggest that you go to the website: duodenalswitch.com There is ample information there on the procedure and a list of surgeons who do it, which I believe now is 22. They are all around the country, and their names and addresses are on that site. There is also a chat room which is posted on the site as well. Good luck in your information gathering.
   — Julie P.

March 8, 2000
Louise, the report that Melanie posted is by the man who developed the BPD and has performed thousands of them. You can print the report and take it to your doctor. It may give her or him a direction to investigate. Information is power, and the internet is a powerful tool for gathering information. Kudos to you for making use of it!!
   — Kim H.

April 16, 2000
There are several advantages to the biliopancreatic bypass with a duodenal switch. There is no isolated stomach, no foreign body or band required. There is preservation of the pylorus, no dumping syndrome, no marginal ulcers, and good weight loss. This operation is both a restrictive and a malabsorption procedure. However, neither of these procedures are performed to an extreme degree. The restriction is related only to reducing the size of the stomach. There is no constricting band or narrowed stoma. We use a vertical gastrectomy which preserves the pylorus, a portion of the antrum, some of the mid and upper stomach, and removes most of the acid producing fundus. If in the future any revision needs to be performed on these patients it would be unusual to have to re-operate on the stomach. Surgery in this area becomes difficult due to adhesions between the stomach, liver, and the upper abdominal area on the second surgeries. The malabsorption portion of this operation consists of an alimentary canal of 250 to 350 cm, with a common channel portion measuring 50 to 100 cm. of the distal ileum, which practically always gives adequate absorption and nutrition. If there is some difficulty with malabsorption, the length of the alimentary canal and common channel can be extended without much difficulty and without disturbing the stomach or the duodenal anastomosis. Liver failure, renal failure, severe electrolyte imbalances etc. do not seem to be a problem with this operation, if the patients have adequate follow-up and proper supplementation. Since the pylorus is still intact a functional reversal of this operation can be performed quite satisfactorily. The volume of the stomach, 100 to 175 cc, will enlarge with time, and is always adequate in size. Shortening of the roux-en-y or anatomical reversal would work without the formation of an ulcer or the need of a vagotomy. It is known that the gastric bypass with both a short or long limb roux-en-y may be an ulcergenic operation. By the addition of the duodenal switch procedure the possibility of a marginal ulcer is remote 9. We have never had a marginal ulcer since using the duodenal switch procedure in all of our cases, which including our redo surgeries, number more than 600 procedures. Since we do not remove the pylorus and do not have marginal ulcers there is little need for a vagotomy, and in turn, no dumping syndrome, We have never had a dumping syndrome in any of our cases. In our 20 years of experience, the biliopancreatic bypass with a duodenal switch has shown to be the most effective weight loss procedure, for both the morbidly obese and the super morbidly obese patient. For the super morbidly obese patient, restrictive procedures alone will probably not be successful. The biliopancreatic bypass with a duodenal switch, however, is a procedure that has shown to be a successful method of treatment for the super obese patient.
   — [Anonymous]




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