Biliopancreatic Diversion with Duodenal Switch

The Procedure

The Biliopancreatic Diversion with Duodenal Switch, known as a "duodenal switch", is the least commonly performed weight loss surgery in the United States. This procedure is the most technically challenging weight loss surgery. It is geared towards treating patients who have a higher body mass index or "super-obese" patients.

This procedure has two main components. First, a smaller stomach is created by removing a portion of the stomach, similar to that of the Sleeve Gastrectomy. Second, a large length of the small intestine is bypassed, which is accomplished by dividing the proximal portion of the small intestine and connecting to the distal small intestine. The end result of this is that post procedure only the last one fourth of the small intestine absorbs calories, and it also works similarly to that of the Gastric Bypass by implementing several mechanisms including altered gut hormones which are responsible for hunger and cause type 2 diabetes.


  1. Results in a greater weight loss than that of the Gastric Bypass or Sleeve Gastrectomy
  2. Is the most effective weight loss surgery against type 2 diabetes in the long term
  3. Has the least risk of weight regain in the long term


  1. Has higher complication rates than that of the Gastric Bypass and the Sleeve Gastrectomy
  2. Has a greater potential to cause protein and vitamin deficiencies
  3. Requires long term follow-up visits and adherence to dietary and vitamin intake in order to avoid serious complications

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