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| Laparoscopic duodenal Switch |
 The duodenal switch (DS) is a modification of the BPD designed to prevent ulcers, increase the amount of gastric restriction, minimize the incidence of dumping syndrome, and reduce the severity of protein-calorie malnutrition. However, the dumping syndrome is also believed by many to be a benefit, rather than a detriment, in that it helps patients avoid eating sugary and high fat foods which would adversely affect weight loss. The DS was first reported by Dr. Doug Hess in 1986.
These procedures have some of the highest reported weight loss in long-term studies, but also have the highest rate of nutritional complications compared to the Gastric Bypass and the purely restrictive procedures. These operations are some of the most complex in bariatric surgery.
Advantages of BPD and DS:
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Increased amount of food intake compared to the bypass and band |
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Less food intolerance |
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Possibly greater long-term weight loss |
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More rapid weight loss compared with gastric banding procedures. |
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Diarrhea and foul smelling gas, with an average of 3-4 loose bowel movements a day |
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Malabsorption of fat soluble vitamins (Vitamins A, D, E and K) |
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Vitamin A deficiency, which causes night blindness. |
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Vitamin D deficiency, which causes osteoporosis |
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Iron deficiency a similar incidence with the RYGBP |
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Protein-calorie malnutrition, which might require a second operation to lengthen the common channel |
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Ulcers (less frequent with DS) |
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Dumping syndrome (less frequent with DS) |
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