Bariatric Procedure

Duodenal Switch


Biliopancreatic Diversion with Duodenal Switch

The duodenal switch, also known as the biliopancreatic diversion with duodenal switch or DS for short, is a complicated and less commonly performed procedure. At our practice, we typically recommend the duodenal switch procedure for our heavier patients. The duodenal switch weight loss surgery is a combination of the gastric sleeve and gastric bypass. Therefore, this procedure is non-reversible.

Longer Life
Improvement or resolution of serious medical conditions
More Happiness
Improvement in overall health and quality of life
Lower Medical Costs
Long term cost savings as a result of reduced medical care
How Its Done

In performing the duodenal switch, the surgeon creates a sleeve gastrectomy by removing a significant portion of the stomach. Then, the surgeon will divide the small intestine just beyond the stomach as well as about 75% downstream. The lower portion of the intestine is connected to the stomach while the upper portion is reconnected further downstream.

As a result, food will travel down one path, and the digestive juices will travel down another. The food and digestive juices will meet up again approximately 75% further downstream. This results in significant malabsorption.

This operation is not only shrinking the stomach size but is also shortening the small intestine by about 75%. Thus, resulting in smaller portions of food consumed and the faster movement of food through your digestive system.

The duodenal switch weight loss surgery takes about 3 hours to perform, and patients can expect to stay at the hospital for up to 2 days after surgery. Depending on the type of work performed, patients will be able to return to work within 2 to 4 weeks from surgery.

Results that change lives.
Average Weight Loss
80%- 100% of excess weight loss
Diabetes Resolution
98+% patients cured of diabetes
Reduction in Medication Use
80+% free from medication
Quality of Life
100% Improvement
Duodenal Switch Risks
Potential Risks

Before considering the duodenal switch, it is important to be familiar with the potential risks of bariatric procedures. Risks vary based on the health of the patient.

  • Minor Complications
  • Major Complications
Minor Complications
  • Minor wound or skin infection
  • Excess / loose skin
  • Vomiting or nausea
  • Acid reflux (heartburn)
  • Changes in bowel habits like constipation, diarrhea, bloating, cramping, or gas
  • Development of gallstones or gallbladder disease
  • Nutritional deficiencies as a result of food bypassing the stomach
Duodenal Switch Risks
Major Complications
  • Internal bleeding
  • Intestinal obstruction
  • Blood clots in the legs or lungs
  • Internal hernia
  • Perforation of stomach/intestine or leakage
Duodenal Switch Risks
Duodenal Switch FAQs
Should I get the duodenal switch or the gastric bypass?
The duodenal switch and gastric bypass both have restrictive and malabsorptive components in which a new connection between the stomach and small intestine is surgically created. The duodenal switch has a higher level of malabsorption though. This leads to more weight loss when compared to the gastric bypass. The duodenal switch is best performed on patients with a BMI greater than 60, who are looking for better results. However, it is important to keep in mind the risks and lifestyle changes that come with the duodenal switch.
How much weight will I lose after duodenal switch surgery?
Research shows that patients will lose between 80 and 100% of their excess weight. Patients who achieve greater success after duodenal switch surgery are those individuals who follow their surgeon and dietitians' instructions and incorporate exercise into their daily activities.
Who is a good candidate for duodenal switch surgery?
Patients who are looking to have the duodenal switch must first qualify for bariatric surgery. To qualify, you must have a BMI over 40, however for patients seeking the duodenal switch procedure, we recommend they have a BMI greater than 60 and weight-related medical conditions (i.e. diabetes, sleep apnea, heart disease, etc.). Patients who are interested in the duodenal switch must also be committed to a life long change in their eating habits and lifestyle. This procedure is non-reversible, therefore deciding to have a duodenal switch is a serious decision. Due to the malabsorptive nature of this procedure, patients must be committed to taking their vitamins for life after surgery. Nonetheless, candidates for duodenal switch surgery can expect to lose a significant amount of weight and experience a better quality of life.
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