BPD (Biliopancreatic Diversion)

A biliopancreatic diversion is a surgical procedure done to reduce the stomach by about 75% to largely restrict food intake as well as reduce acid ouput. The goal behind BPD is to limit the amount of food one consumes in a sitting, as well as reduce the amount of digestion and the subsequent increase in body weight. The surgeons create a diversion on the small intestine diverting pancreatic and bile juices from coming into contact with ingested food. The diversion bypasses almost half the length of small intestines to reduce digestion and food absorption. Only a small amount of these digestive enzymes are exposed to the food thus reducing amounts of food digested and nutrients absorbed into the blood stream. Calorie and nutrient absorption is significantly reduced.

With the ingested food materials bypassing the duodenum, any of the risk considerations outlined in the ‘gastric bypass’ section apply to these techniques.

Biliopancreatic Diversion (BPD)

Biliopancreatic Diversion (BPD) removes about 3/4 of the stomach thus inhibiting food intake to a large degree. Enough upper stomach is left in place to ensure there is proper nutritional balance. The procedure also involves attaching a part of the stomach pouch a section of the small intestine creating what is known as an alimentary limb. All ingested food materials are diverted into this segment but reduce absorption of nutrients. Pancreatic juices and bile move into the ‘biliopancreatic limb’ connected to the remaining half of the small intestines. This helps supply digestive enzymes (to the ‘common limb’) that facilitate the breakdown of food materials for absorption. The surgeon is fully able to monitor and change the common limb’s length to regulate protein, fat, and vitamin absorption in the patient.

“Duodenal Switch” biliopancreatic diversion

This procedure differed from BPD where only the outer margin is removed leaving the stomach sleeve with the pylorus and the duodenum. The duodenum is the first segment of the small intestine and is divided to bypass both the bile and pancreatic drainage. The beginning of duodenum is the attached to the end of the ‘alimentary limb’, and the ‘common limb’ attached in a similar way.

Advantages of BPD

Patients can enjoy more satisfying and larger meals without having to worry about weight gain or obesity. These procedures aren’t restrictive as it is with a standard Roux-en-Y gastric bypass.

These procedures enable patients to lose very large amounts of weight and body fats due to a high level of nutrient malabsorption. As long as food nutrient absorption is limited, then the body only gets the little it needs to keep going. Patients suffering from morbid obesity can lose up to 70% of their weight within a matter of one year. This number was calculated according to a study conducted on the success of 125 patients undergoing these treatments.

These procedures are effective especially when looking for long-term weight reduction. For definite results when using these procedures to tone down, it would be advisable to stick to/adhere to straightforward supplements, dietary and behavioral regimen.

Risks involved

Some healing time is needed to allow the malabsorption procedures to be possible as well as allow the intestines to adapt to the new ‘routes/configuration’. Some patients may start passing frequent and liquid stools over time though these declines as time go by.

Malodorous gas or stool may occur due to abdominal bloating.

Lifelong monitoring for anemia, protein malnutrition and bone disease is recommended. Patients are also advised to take vitamin and mineral supplements. This is because the body may not be able to synthesize or absorb enough vitamins as required. A quarter of patients will usually require some follow up treatment.

BPD may increase the risk of gallstone formation that may require gallbladder removal. This procedure may also cause intestinal ulcers and irritation due to rerouting of pancreatic juices and bile.

Your weight loss surgeon will be able to further outline complications that may occur.