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Duodenal Switch Surgery

October 22, 2021 / By Nihat.Gulaydin-2021 / Posted in Obesity Surgery

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The duodenal switch (DS) procedure is also known as biliopancreatic diversion with duodenal switch. This technique is a modification of the original biliopancreatic diversion described by Scapinaro in 1979. Like gastric bypass surgery, it is a restrictive and malabsorptive procedure. Similar to duodenal switch, sleeve gastrectomy, the stomach is first transformed into a less curved tube. The duodenum is divided beyond the pylorus. A Roux-en-Y limb is then reconstructed to create a common channel approximately 1 m from the ileocecal valve.

What are the advantages?

  • It is stated that with the duodenal switch method, there is a lot of weight loss in super obese people and that diabetes is completely cured in more than 95% of patients with type II diabetes. Another advantage of the duodenal switch is that it protects the pylorus between the stomach and small intestine, thus preventing dumping syndrome, which is common after gastric bypass.

  • This procedure is very successful in reducing co-morbidities such as diabetes, hypertension, sleep apnea and others.

What are the disadvantages?

  • The procedure is technically more difficult than gastric bypass and has higher complication rates.

  • Nutrient deficiencies are very common with this procedure because it not only limits your calorie intake but also restricts your body's opportunity to absorb minerals and vitamins. This procedure is also associated with particularly foul-smelling stools, a high risk of osteoporosis, increased gas, and poor bowel control.

Who Can Perform Duodenal Switch Surgery?

  • It can be applied to all patients between the ages of 16 and 65 who have an indication for obesity surgery. The limits for obesity surgery accepted by the World Health Organization and the World Federation of Obesity and Metabolic Surgery are people with a body mass index of 40 or 35 + a comorbid disease. If there are diseases such as diabetes, sleep apnea, joint disorders, fatty liver, coronary artery disease, hypertension and hyperlipidemia due to obesity, a body mass index of 35 and above is sufficient for surgical intervention.

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