Biliopancreatic Diversion with Duodenal Switch (BPD/DS)- Bariatric Surgery

What is Biliopancreatic Diversion with Duodenal Switch (BPD/DS)?

A biliopancreatic diversion with duodenal switch (BPD/DS) is a lesser-known surgical technique for weight loss that involves two steps: sleeve gastrectomy and intestinal bypass.

The initial step is sleeve gastrectomy in which around 80 percent of the stomach is removed, leaving a smaller, tube-like stomach. However, the valve that discharges food to the small intestine via the pyloric valve stays, along with a smaller part of the small intestine that ordinarily interfaces with the stomach or the duodenum.

The second step will bypass most of the intestines by associating the end part of the intestines to the duodenum close to the stomach. A BPD/DS can limit the amount you can eat and diminishes the absorption of nutrients such as proteins and fats.

Why Is Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Required?

A BPD/DS is suggested for individuals with a body mass index (BMI) of more than 50.

Which Doctor to Consult?

A team of medical experts, including endocrinologists, surgeons, dietitians and psychologists, helps identify candidates who could most benefit from weight-loss surgery. This team works intensively with you before and after your procedure to help achieve a long-lasting result.

What to expect during the procedure

A BPD/DS is regularly done after you've attempted to lose weight with diet and physical activity.

However, a BPD/DS isn't for everyone who is overweight. You will likely have a screening procedure to check whether you qualify.

You should likewise be willing to make permanent improvements towards a healthy way of life before and after the surgical procedure. This may include long-term follow-up plans that include observing your nutrition, your way of life and behavior, and your overall health condition.

Your surgical procedure relies upon your individual condition and your doctor’s choice. A few surgical procedures are created with open abdominal incisions, while others might be performed laparoscopically, which includes inserting some instruments through little cuts in your abdomen.

The initial step of a BPD/DS procedure includes removing a part of the stomach. After creating cuts with the open or laparoscopic method, your doctor removes a large part of the stomach and structures the remaining parts into a narrow tube. Your doctor leaves the valve that discharges food to the small intestine, through the pyloric valve, alongside a small part of the small intestine that usually connects with the stomach or duodenum.

The second step of a BPD/DS involves making an incision through the portion of the small intestine just underneath the duodenum, and a second incision down, close to the lower end of the small intestine. Your specialist then brings the cut end close to the base of the small intestine up to the next cut end, just underneath the duodenum. This is done to bypass a large section of the small intestine.

The surgical procedure may take only a few hours. After the surgical procedure, you will remain in a recovery room, where the medical staff monitors your condition.

Post-operative care

After the BPD/DS procedure, you may have fluids with no solid food, as your stomach and intestines are healing. You will then follow a diet plan that changes gradually from fluids to soft foods. After that, you can eat soft foods, and later on you can have solid foods, if you can tolerate them.

Your doctor may prescribe you with vitamins and minerals after the procedure, including a multivitamin, calcium and vitamin B12. These are all essential to avoid micronutrient deficiency.

You'll additionally have follow-up checkups to monitor your condition in the initial months after weight reduction surgery. You may require laboratory testing, and different tests.


Complications may include bleeding, infections, breathing problems and others. It is best that you get some information about its complications from your doctor so that you can prepare well for your surgery.


  1. MayoClinic. Accessed January 17, 2019.
  2. Bariatric Surgery Procedures | ASMBS. American Society for Metabolic and Bariatric Surgery. Published 2019. Accessed January 25, 2019.

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