Question:
what is the difference between open rny and extensive gastric bypass

I would like to understand the difference between the two surgerys, open RNY and Extensive Gastric Bypass ( Biliopan Creatic Diversion), I have viewed the different surgery page and still do not understand, it looks to me like the latter of the two would be the better of the two, as far as fast and most weight loss. any help anyone can give me would be most helpful. tks ann    — ann shelia J. (posted on February 12, 2000)

February 12, 2000
Extensive Gastric Bypass will, indeed, help you to lose weight faster! However, the risks are greater because you have very little chance of getting enough nutrition from your food. The Extensive Gastric Bypass also removed the stomach. "In this more complicated gastric bypass operation (figure 5), portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, thus completely bypassing both the duodenum and jejunum. Although this procedure successfully promotes weight loss, it is not widely used because of the high risk for nutritional deficiencies." That's the difference! You want to lose the weight, but you don't want to kill yourself, do ya?
   — Cindy H.

February 12, 2000
This is a pretty complicated question. There are different kinds of RnY to consider, and the BPD you asked about is often combined with a "duodenal switch" which makes it different too. Here is my understanding of it: RnY creates a small stomach pouch (restricts the volume of food) and bypasses a portion of the small intestine (reduces the absorption of food). There is a stoma between the stomach pouch and small intestine which allows food to pass freely and can result in dumping if you eat sugary foods. The Biliopancreatic Diversion with Duodenal Switch has a larger stomach volume than most RnY's (so you can eat bigger meals), but more of the small intestine is bypassed than most RnY's (so you absorb less of the calories). And, with the duodenal switch, there is a working valve between the stomach and small intestine instead of a stoma. This regulates the passage of food into the small intestine and eliminates dumping. So, the advantages of the RnY would be you have dumping to deter you from eating sweets, and you don't have an extensive bypass, so you are less likely to get vitamin or protein deficiencies. The advantages of the BPD/DS would be that you don't have dumping if you choose to eat sweets occasionally, and you can eat a "normal" sized meal, and you have no stoma to worry about stretching or getting blocked, etc. I'm not too sure about the weight loss part. With RnY I think the average person loses 80% of their excess weight. Someone else may be able to tell you the stats for BPD/DS. Hope this makes sense!
   — Lynn K.