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Duodenal Bypass
/ Switch
Surgery, Dubai
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About The
Duodenal Bypass
Procedure
The Duodenal
Switch
procedure (also
called vertical
gastrectomy
with duodenal
switch,
biliopancreatic
diversion with
duodenal
switch, DS or
BPD-DS) is
performed by
approximately
50 surgeons
worldwide. It
generates
weight loss by
restricting the
amount of food
that can be
eaten (removal
of stomach or
vertical
gastrectomy)
and by limiting
the amount of
food that is
absorbed into
the body
(intestinal
bypass or
duodenal
switch).
It is more
controversial
because it has
a significant
component of
malabsorption
(bypass of the
intestinal
tract), which
seems to
augment and
help maintain
long-term
weight loss. Of
the procedures
that are
currently
performed for
the treatment
of obesity, it
seems to be the
most powerful
and effective,
but may also
have more
complications
associated with
it.
The BPD/DS
combines
restrictive and
malabsorptive
elements to
achieve and
maintain the
best reported
long-term
percentage of
excess weight
loss among
modern
weight-loss
surgery
procedures.
The
Restrictive
Component
The BPD/DS
procedure
includes a
partial
gastrectomy,
which reduces
the stomach
along the
greater
curvature,
effectively
restricting its
capacity while
maintaining its
normal
functionality.
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Unlike the
unmodified BPD
and RNY, which
both employ a
gastric “pouch”
and bypass the
pyloric valve,
the DS
procedure keeps
the pyloric
valve intact.
This eliminates
the possibility
of dumping
syndrome,
marginal
ulcers, stoma
closures and
blockages, all
of which can
occur after
other gastric
bypass
procedures.
In addition,
unlike the
unmodified BPD
and RNY
procedures, the
DS procedure
keeps a portion
of the duodenum
in the food
stream. The
preservation of
the
pylorus/duodenum
pathway means
that food is
digested
normally (to an
optimally
absorbable
consistency) in
the stomach
before being
excreted by the
pylorus into
the small
intestine. As a
result, the DS
procedure
enables
more-normal
absorption of
many nutrients
(including
protein,
calcium, iron
and vitamin
B12) than is
seen after
other gastric
bypass
procedures.
The
Malabsorptive
Component
The
malabsorptive
component of
the BPD/DS
procedure
rearranges the
small intestine
to separate the
flow of food
from the flow
of bile and
pancreatic
juices. This
inhibits the
absorption of
calories and
some nutrients.
Further down
the digestive
tract, these
divided
intestinal
paths are
rejoined; food
and digestive
juices begin to
mix, and
limited fat
absorption
occurs in the
common tract as
the food
continues on
its path toward
the large
intestine.
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