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Bilio Pancreatic Diversion

An Introduction to BPD & BDP/DS

BPD stands for Bilio Pancreatic Diversion and BPD/DS stands for Bilio Pancreatic Diversion with Duodenal Switch.

What is done in BPD & BPD/DS?

In BPD procedure, 3/4th of the stomach is removed horizontally whereby the upper part of the stomach is retained completely.

In BPD / DS procedure, 3/4th of the stomach is removed vertically exactly similar to gastric sleeve procedure.

The above two forms the restrictive portion of the bariatric surgery.

After this procedure is completed, in both BPD and BPD/DS, two separate pathways are created. One pathway is called the digestive pathway, where a connection is made from the end of the stomach to the common pathway usually in the end portion of the small intestine. Another pathway is the bilio pancreatic loop which carries bile from the liver to this same common pathway. Here since major small intestine part is bypassed, the nutrient absorbing capacity of the little food that is consumed is greatly reduced. So, essentially this part of the procedure forms the malabsorption portion of the bariatric surgery.

Who are the candidates for the Duodenal Switch Bariatric Procedure?

Generally, individuals who are super obese, with a BMI of greater than 50 are candidates for both the procedures. It may be noted that the super obese invariably would be having severe co-morbid conditions like Type-2 Diabetes, Sleep apnea, Heart diseases, High BP, High cholesterol etc. So it is found that BPD and BPD/DS procedure gives them relief from the above said co-morbid conditions to a great extent.

In my personal experience, I would recommend BPD for super obese male and BPD/DS for super obese female. The reason is simple. In BPD/DS, minimal area of distal part of stomach is retained where calcium, iron and other vitamin b12 absorption takes place. Since women face osteoporosis (thinning of bone due to demineralization) at menopause, BPD/DS is preferred.

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