Duodenal Switch

The Biliopancreatic Diversion with Duodenal Switch is a weight loss surgery procedure that combines the restriction of the Gastric Sleeve with the malabsorptive qualities of the Gastric Bypass.

The biliopancreatic diversion with duodenal switch is a weight loss surgery procedure that combines the restriction of the gastric sleeve with the malabsorption qualities of the gastric bypass. The result is greater weight loss than gastric bypass, gastric sleeve or gastric band, with studies showing that patients who have biliopancreatic diversion with duodenal switch achieve 60 to 70 percent of excess weight loss or more at five-year follow up.* In the past, duodenal switch has been recommended for patients with a body mass index (BMI) greater than 50, but it can also be performed on patients with a BMI of 40 or above.

How the Duodenal Switch Works

First, a small tubular stomach pouch —very similar to the pouch created in the sleeve gastrectomy— is created by removing a portion of the stomach. During the second portion of the procedure, the small intestine is divided. One segment (the distal) is connected to the stomach sleeve. The other section (the duodenum) is reconnected to the small intestine. When the patient eats, the food goes through the stomach pouch and empties directly into the last segment of the small intestine, bypassing three-fourths of the small intestine. Bile and pancreatic enzymes are carried through the bypassed section of the small intestine and meet up with the food in the last section of the small intestine.

The duodenal switch initially helps to reduce the amount of food that is consumed. Since the food does not mix with the bile and pancreatic enzymes until very far down the small intestine, there is a significant decrease in the absorption of calories and nutrients (particularly protein and fat).

The duodenal switch affects hormones that reduce hunger, increase satiety and improve blood sugar control. The duodenal switch is considered to be the most effective surgery for the treatment of diabetes. Read more about the health benefits of weight loss surgery.

Benefits vs. Risks of Duodenal Switch

Studies have found numerous health benefits associated with duodenal switch surgery, including:

  • Duodenal switch causes favorable changes in gut hormones to reduce appetite and improve satiety
  • Duodenal switch has been found to be the most effective against diabetes compared to gastric bypass, gastric sleeve and gastric band
  • Greater weight loss than gastric bypass, gastric sleeve and gastric band surgeries.* Duodenal switch reduces the absorption of fat by 70 percent or more

However, as with any surgery, there are risks. When deciding whether duodenal switch surgery is right for you, the perceived benefits must outweigh the potential risks. To learn more about specific complications of this procedure, visit our Risks page.

*Results vary